The term “shin splints” is part of most athletes’ vocabulary, but few people are familiar with their cause, treatment and prevention.
Shin splints generally refer to pain in the shin bone, or tibia. This pain is most commonly found in the front-outside (anterior, lateral) aspect of the tibia, in a muscle called the anterior tibialis. To feel exactly where this is, sit in a chair and run your right hand down the front of your right shin, with fingers pointed toward your foot. You should feel a ridge in the center of the tibia that runs between the bump under your knee to right above your ankle. The muscle immediately to the right of the ridge is the anterior tibialis. If this area is tender to touch or hurts when walking, you may have shin splints.
In some less common cases, shin splints can occur in the back of the tibia, on the inside (medial) part of the leg. In this article, we will focus on the more common anterior shin splints.
To understand what causes shin-splint pain, a little anatomy has to be explained. The anterior tibialis muscle (painful muscle in shin splints) is responsible for bending the ankle up or bringing the ball of the foot up while the heel is still on the floor. This motion is called dorsi-flexion.
When this muscle is over used or when it is strained by abnormal biomechanics of the foot, it becomes tight. This fleshy muscle is attached directly to bone along the upper 2/3 of the tibia. During repetitive strain or intense over exertion, fibers of the muscle actually pull at the attachment sites along the length of the tibia. Inflammation results.
There are several common ways to strain the anterior tibialis muscle. The most common is simply increasing your running or exercise too quickly. For example, if you typically run 1-2 miles a day, and increase your running to 4-5 miles a day without gradual buildup, you are at risk.
Tight calf muscles are another cause of shin splints. The calf muscle is actually composed of 2 separate muscles, the gastrocnemius (the more superficial, two-belly muscle) and the deeper soleus muscle. Since the anterior tibialis muscle counterbalances the calf muscles, exercising with tight calf muscles to start with adds unnecessary strain. After you check with your doctor, learn specific stretches for both gastrocnemius and soleus muscles. This is a crucial step in prevention of shin splints.
Lastly, make sure you wear a good pair of supportive athletic shoes. It is more common for people with flat feet to develop shin splints since they tend to over-pronate the foot when the run. This means that the arch of the foot collapses with each step. Change running shoes every 6 months or as soon as they start to loose their shape. Occasionally, defects in even a good pair of name brand running shoes occur. If your shoes don’t feel right, don’t wear them!
If you have already developed shin splints, try these simple suggestions.
- Fill several 3 oz. paper cups with water and put them in the freezer. Once frozen, take one out and peel away ½ inch of the top of the cup and massage the shin-splint area for 7 minutes with ice. Do this several times a day, especially after you exercise.
- Cut your workouts in half, and skip a day between them. Gradually increase your activity over a period of 2-4 weeks, depending on your pain level.
- Taking an anti-inflammatory over-the-counter medication, such as aspirin, ibuprofen or naproxin (Aleve) may also prove helpful.
Remember, stretch and exercise in moderation to stay healthy and injury free.