Let me ask you a very stupid question. ‘Are you afraid of running?’ Well, many people are because 30 to 70 percent of runners end up injured every year. And, shin splints are the cause of 35% of those injuries. Now, you may be thinking what this shin splint is! It’s a pain you feel in the shin bone of the lower leg. Heavy physical activity and excessive training is the basic cause of this pain. And, now you are thinking twice before running, right! Don’t worry. In this article, I will guide you through that shin bole area and tell you exactly how to avoid shin splint.
Definition of Shin Splints
The term ‘shin splint’ depicts the pain that you feel along the front of the lower leg, at the shin bone. First and foremost, the pain usually concentrates in the lower leg between the knees and ankle. However, you might hear your doctor to term the pain as ‘Medial Tibial Stress Syndrome (MTSS).’
The American Medical Association characterizes shin-splint syndrome as ‘Pain and discomfort in the lower leg.’ It is a cumulative stress disorder. Repetitive loading stress during running and jumping causes this intense pain. On the other hand, people who do moderate to heavy physical activity are prone to this syndrome. The American Medical Association has conducted a study on shin splint. And according to them, 4% to 35% of athletic and military populations suffer this pain.
Misconceptions about Shin Splints and the Pain
Once, my colleague told me that he is feeling intense pain in the lower leg. I knew he was from the military. Besides he loved to work out. With the symptoms, I was in no doubt that it might be related to the shin-splint syndrome. He went to consult a doctor and got some tips and meds. But, didn’t get any relief from the pain!
It is no wonder that the doctor fails to consider or treat the problem since there are several issues involving shin splints that doctors or the therapists are uninformed about. They probably don’t know how to avoid shin splint. You can’t find any ‘shinologists,’ and for most professionals, shin pain is just another pain problem they deal with every day. In fact, most of the professionals are unaware of the finer points of the subject and the recent scientific researches. They rely upon the quarter-century-old conventional wisdom. Such huge gaps in professional information make it intense for patients to discover capable help for more serious and obstinate instances of shin pain.
Professional knowledge gaps
In this segment, I would like to show you some common and critical shin splint concepts or factors that doctors and therapists are usually not aware of. Most of them also don’t know, how to avoid shin splints.
Acute Compartment Syndrome
Acute Compartment Syndrome is a symptom of widespread ignorance about the causes of shin pain. Although, many health professionals do not understand how lethal a shin pain can actually be.
Since health care has a huge blind spot for muscle, professionals almost always underestimate or miss the muscle’s role in the injury. In many cases of shin pain, painful muscular dysfunction is a significant factor.
Another critical shin splint concept is tissue fatigue. As a matter of fact, many health professionals focus only on the mechanics of tissue rather than chemistry.
Causes and Vulnerability
The pain related with shin splints results from an extreme amount of force on the shin bone and the tissues attaching the shin bone to the muscles encompassing it.
The excessive force makes the muscles swell and increases the pressure against the bone, prompting pain and inflammation.
Shin splints can likewise result from stress responses to bone fractures. The consistent pounding can cause minute cracks in the bones of the leg. The body can fix the splits whenever offered time to rest.
It is very common with running and jumping athletes. In addition, women have an increased risk to incur this injury, especially with this syndrome. This may happen because of nutritional, hormonal and biomechanical abnormalities.
There are also some factors that may add to the vulnerability of shin splint-
- Flat feet – when the effect of a step makes your foot’s curve collapse
- Bad running shoes that don’t fit well in the foot
- Exercise without warm up or cool down stretches
- Weak ankles, core muscles or hip
- Running or jumping on uneven surfaces
- Cold weather
Internal chronic inflammation of the muscular connection along the posterior medial tibia and bony changes can also cause the medial tibial stress syndrome. In fact, we have to know these causes to know how to avoid shin splints.
Who gets most affected?
As I have said in the earlier parts that athletes, military personnel, dancers are among the most affected victims of this syndrome. Excessive training, weight-pulling, incorrect techniques of workout can put you in the harm’s way.
Moreover, there are some others activities and physical attributes that can put you at risk of getting shin splints.
Peoples who do have biomechanical abnormalities like foot arch abnormalities, hyper pronation of the foot, unequal leg length can suffer ‘Medial Tibial Stress Syndrome’ or (MTSS).
Comparing with men women are the most affected groups of this syndrome. Because of nutritional, hormonal and biomechanical abnormalities women have an increased risk of shin splint.
Individuals having excessive weight
People who have excessive weight are more susceptible to getting this syndrome. Therefore, individuals who are overweight must lose weight before starting any therapy or training program.
The risk factors are related to the issue of MTSS or ‘Medial Tibial Stress Syndrome.’ It is very important to screen these risk factors before starting the treatment. We can divide them two categories such as intrinsic factors and extrinsic factors. In the next two tables, you can find the complete list of risk factors regarding MTSS or, shin split syndrome.
|Femoral neck anteversion|
|Aerobic endurance/ conditioning|
|The strength of and balance between|
|The flexibility of muscles/ joints|
|Flexors and extensors|
|Sporting skill/ coordination|
|Type of sport|
|Exposure (e.g., running on one side of the road)|
|Nature of event (e.g., running on hills)|
Signs that Tell You Have Shin Splints
The primary symptom is dull pain located along the second third of the length of the posteromedial tibia. Mellow oedema in this agonizing region may also be present. The symptoms are frequently bilateral. The pain is caused by continued landing and take-off from a hard or uneven surface. This pain intensifies at every moment of contact. At first, the patient just feels pain toward the start of the exercise, regularly vanishing while working out, just to return amid the chill off period. At the point when shin splints deteriorate the pain can stay amid exercise.
The most well-known entanglement of shin-supports is a stress fracture, which shows itself by the delicacy of the front tibia.
Neurovascular signs and symptoms are not regularly owing to MTSS and when present, different pathologies, for example, chronic exertional compartment syndrome (CECS) or vascular deficiencies ought to be considered as the source of leg pain.
Individuals with shin splint may experience some of the following symptoms:
- A pain that will rise during exercise
- Pain surrounding the shin bone
- Pain in the muscle
- A feel of pain alongside the inner part of the lower leg
- Soreness or tenderness alongside the inner part of the lower leg
- Mild swelling in the lower leg
- Weakness or numbness in the feet
After talking about your symptoms and medical history, your specialist will analyze your lower leg. A precise diagnosis is vital. Once in a while, different issues may exist that can affect the healing.
Your specialist may arrange extra imaging tests to rule out other shin issues. A few conditions can cause shin pain, including stress fractures, tendinitis, and chronic exertional compartment disorder.
If your shin splints are not receptive to treatment, your specialist might need to ensure you don’t have a stress fracture. Stress or overuse causes a little crack(s) in the tibia, and we term it as a stress fracture.
Imaging tests may help to diagnose conditions. A bone scan and MRI (Magnetic Resonance Imaging) study may show a stress fracture in the tibia.
Ligaments or tendons join muscles to bones. Tendinitis happens when ligaments end up kindled. This can be agonizing like shin splints, particularly if there is a fractional tear of the involved ligament. An MRI may help diagnose tendinitis.
Chronic Exertional Compartment Syndrome
An exceptional condition like chronic exertional compartment syndrome causes symptoms like shin splints. Compartment syndrome is an excruciating condition that happens when the pressure inside the muscles builds to unsafe levels. In chronic exertional compartment syndrome, this is expedited by exercise. Pain generally settles not long after the movement stops.
Measuring the pressure within the leg compartments before and after can help diagnose this condition.
Your doctor or professional may also go for some other differential diagnosis to make sure if the pain is really a shin splint. These may include:
- DVT or, Deep Vein Thrombosis
- Popliteal Artery Entrapment
- Muscle Strain
- Arterial endofibrosis
- Nerve entrapment
‘How to heal shin splints fast?’ This is the question of many. Well, shin splint usually heals on their own. You don’t need to take any extravagant measures to treat this condition. And, neither your doctor will suggest any. Shin splints need you to take a break from certain physical exercises and give your legs time to rest. The distress will generally resolve totally in a couple of hours or at most in a couple of days with rest and restricted movement.
The recommended measure of downtime is commonly around about fourteen days. Amid this time, you can take part in games or exercises that are less likely to make extra damage to your legs. These exercises incorporate swimming or walking.
You can categorize the standard treatment procedure in two parts. These are- taking rest or surgery in extreme conditions.
As I have said earlier, in most cases, you can cure the shin splint all by yourself. You ought to give some rest to your leg as per the doctor’s suggestion. A time off from your exercise or work will heal your condition in a few days.
Individual rarely has to undergo a surgery to treat shin splints. However, if the condition is causing extreme pain and symptoms keep going for over a while, your specialist may suggest surgery.
This medical procedure is known as a fasciotomy. In this technique, your specialist will make little cuts in the fascia tissue encompassing your lower leg muscles. This may mitigate some of the pain.
Treating Shin Splints at Home
You can treat your shin splints at home. Your doctor may recommend you do some stuff and that will definitely heal the condition. Doctors often asked the patients to do the following things.
- Giving the Body Some Rest
- Keeping the Legs Elevated
- Icing the Shin
- Using Insoles/Orthotics for Shoes
- Using a Foam Roller
- Wearing Elastic Compression Bandages
- Taking OTC Anti-Inflammatory Drugs (painkillers)
- Performing Low-Impact Workouts
Giving the Body Some Rest
We all know that extra load or overuse causes the shin pain. Giving the body some rest will work like magic in most of the cases.
Keeping the Legs Elevated
Try to keep your legs on a higher position. It will relax the shin bone and the muscles. Giving any extra pressure may increase the pain or intensify the injury. So, just keep your injured leg elevated, and it will ease the pain.
Icing the Shin
Take the help of an ice pack for icing the shin. It will reduce the swelling.
Using Insoles/Orthotics for Shoes
Using a Foam Roller
You can massage the shin bone area with the help of a foam roller.
Wearing Elastic Compression Bandages
Wearing Elastic Compression Bandages can reduce the pain to a great extent.
Taking OTC Anti-Inflammatory Drugs (painkillers)
Your doctor may recommend taking some OTC Anti-Inflammatory Drugs to heal the pain. And, definitely, this will work.
Performing Low-Impact Workouts
Specialists always recommend taking some rest from the daily activity to heal your shin splints. But, you can perform some low-impact workout, and that may speed up the healing process. However, don’t forget to consult with your doctor first. These workouts may include some cycling, swimming, or weight-training.
How Long DO Your Need to Wait to Get Healed?
You may need to wait for a couple of days to a couple of months to fully recover from the condition. It actually depends on the healing process of your body and the condition of your injury. With the inflammatory process, your body will manage the injured muscle tissue to take it to normal function. The whole inflammatory process should take 7 to 9 weeks.
- The initial phase- lasts for 3 to 7 days. The pain in the front of the shin will be sharp and constant
- The second phase- lasts for 3 to 4 weeks. The body will start to heal the tissue in this stage.
- The final phase- this is the tissue remodeling phase. It should take 2 to 4 weeks.
Some individual may experience the pain last longer than these periods. This may happen if they return to the aggravating activity before the anterior tibial muscle is ready to take the stress. Because of this, you need to take adequate rest and wait for the full recovery before resuming work.
How to know if Your Shin Splints Have Healed?
It is almost impossible to predict exactly when your shin splints will go away. The healing process and the time completely depend on the cause of the condition. I have already mentioned in the previous parts of the article that it might take 7 to 9 weeks to get a full recovery. But, it is not unusual to take more times than that. And, now the question arises that how will you get to know whether your shin splints have healed or not. This is probably not as difficult as predicting the healing time. Just check the following:
- The injured leg has become as flexible as your other leg.
- You will feel the same strength in both of your legs.
- By pushing hard on the injured spot, you will feel no pain.
- And finally, jog, jump, and sprint like before. No feeling of pain will occur.
Do Shin Splints Really Heal?
Many people frequently ask the question, ‘Do shin splints really heal?’ The answer to this question is a simple yes. But, that doesn’t mean that it won’t come again. One very important thing about shin splints is you need to recover from the injury before starting exercise or work fully. It will help you get fully recovered and may lower the risk of future injury.
When to See a Doctor?
In most of the cases, the shin pain started to reduce within a few days. But if the severe pain doesn’t start to ease with few days of rest or home treatment, you should consult with your doctor for further investigation. You have to be sure whether it is shin splint or any other conditions like a stress fracture of the tibia or referred back pain.
Undergoing Surgical Procedures
It is very rare that people need surgery for this condition. When an athlete failed one year’s preservationist treatment or if the condition is repetitive to someone, the doctor may suggest surgery. A posterior fasciotomy is a basic methodology for this condition. It comprises one or more fascial incisions to diminish tension or pressure regularly to treat the resulting loss of circulation. They are commonly not total resolutions but may improve symptoms of pain. Postoperatively patients must pursue an evaluated restoration program like that utilized in non-operative treatment.
Prevention is better than cure
It is no wonder that prevention always works better than healing or curing an injury. When you are running or working out always keep prevention at the forefront of your mind. You should address the factors that can cause shin splints. Be sure to avoid those to prevent shin splint. You can also take some exercise as a preventive measure.
Shin splints often occur when you put excessive pressure on your leg. But sometimes it may also happen when your shins pick up the slack for body parts that are weak. You can protect your shins by strengthening your feet, ankles, calves, and hips with the following exercises.
Running can tighten your calves, and that may pull on the anterior tibias or the shins. Stretching the calves will help to loosen up those muscles. To do this, you need to stand close to a wall, curb or step. Down your heel and raise the toes up to the wall. Make a 45-degree angle or greater. Make a soft bend in the knee, but keep the leg straight.
In addition, you can lean forward or back slightly to add or remove the pressure. When you are doing this on a curb, try to hang the heel of the edge. In this way, the body weight will assist the stretch.
The ABC move
Making ABC with your legs is a quick way to stretch out your legs. This move will make the circulation going, keeps the ankle flexible and stretches out the muscles of your calves. To do this, stand or sit and try to write the alphabet out with the foot. Don’t use the entire lower leg, just the ankle or toe. After finishing the entire alphabet, start doing the same with the opposite foot.
Use of Resistance-Band Wipers
Firstly, place a resistance band around your both feet. Next, use one foot as an anchor and rotate the other one like a windshield wiper from side to side. Finally, do this twenty times for each of the foot. This exercise will help to build the strength in the lower leg.
After a running session rolling out on foam can release the muscle and fascia around the calf. Furthermore, you should do this two to three times per week. It is very simple to perform this exercise. Just kneel on the foam roller. Roll two inches down and one inch up the anterior tibialis muscle. Do it all the way from the lower knee to the ankle.
Block & Ball
This move is quite similar to the rolling out procedure. Besides, it works the same way. Firstly, take a yoga block and place a tennis ball, laccosse ball or a trigger point therapy ball. A harder ball will help to get deeper into the belly of the muscles. Then, use the same method as with the foam roller. Make sure to have a deep breath while reaching any sore spots.
Stand on the floor by barefoot. Simply, spread the toes out as wide as possible and then relax a bit. Repeat it ten times. It will help to strengthen the small muscles in the feet. In addition, this move will keep them healthy.
How to prevent shin splints when walking?
However, walking may not cause shin splint. But, walking in speed or walking for longer periods may cause the syndrome. As a matter of fact, you can easily avoid this by simply bearing the causes of shin pain in mind. You need to remember the following to prevent shin splints while walking.
- Don’t walk for too long without rest
- Try to avoid uneven terrain
- Focus on your shoe whether you are walking comfortably with it
- Don’t attempt walking with an injured foot
A List of Actions to Follow to Prevent Shin Splints
I have already discussed a lot of things regarding the prevention issue. Moreover, the exercises will definitely help you to protect your shins from getting injured. But, here I will give some core ideas or tips that will help you with the preventive measure. Follow the list of actions below.
- Find shoes that offer good support and fit well
- Don’t forget to use shock-absorbing insoles
- Try to avoid hard or uneven surface for exercise
- Gradually increase the intensity of your exercise
- Always warm up prior to any exercise
- Don’t forget to stretch in a proper way
- Try to engage in strength training, such as toe exercise for building calf muscle
- Never attempt any exercise through pain
- Give more focus on low-impact activity like cycling, swimming or walking
- Try to avoid heel striking or toe running
- Take enough rest
No one actually cares or think about shins until they hurt. The pain is too severe, and in addition, you may not be able to touch your feet to the ground. When you knew about the shin splints, you probably are looking at some major downtime. Taking a day or two off may refresh you, but sitting idly at home for several weeks due to shin splint is definitely not something you will want. I have tried to focus on every detail on this condition including the causes, diagnosis, treatment, and also the preventions. Read and know about the syndrome and try to maintain the preventive measures to run smoothly!