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by Patrick McCrann

Shin splints is the name for a painful condition that can develop along the inside and on the front of the shins. It usually occurs along the lower half of the shin, anywhere from a few inches above the ankle to about halfway up towards the knee.

In the early stages of shin splints you may feel a pain that is present at the beginning of a run but which disappears as running continues. The pain will often return after exercise or the following morning. As the injury progresses, you will experience more time with the pain and less time without it. Eventually, if ignored and training continues, the pain may become quite sharp and may focus on a very small area of the bone, which could indicate a stress fracture(!).

How Are They Caused
There can be several causes for shin splints. Possible causes include:

• Tight Achilles and calf muscles.
• An inexperienced runner just beginning to run.
• Running in worn down shoes.
• Excessive uphill running.

Training
In many cases one is able to continue training with a mild case of shin splints. Time off from running may be required in severe cases). To continue on, here are some tips:

Pre-Workout

• Take NSAID one hour before starting to run.
• Heat the affected area just before you run. Use hot towels, a heat pack or put your feet (up to your knees) in a tub of hot water for 15-20 minutes.
• Run on soft surfaces as much as possible to alleviate excessive pounding. If there is room on the side of the road, or next to the sidewalk, find it!

Post-Workout

• Cool down (i.e. walk 2’ for every mile you ran!!!)
• Ice the affected area as soon as possible for 20 minutes. Paper cups filled with water and placed in the freezer (you can tear away the cup as the ice melts down) as well as baggies of ice work well.
• A friction massage using the thumbs may prove to be beneficial. Firmly rub the affected area from the bottom of the leg upward.

Prevention
Stretch
Stretching the calf muscles can help prevent the injury from returning. The little muscle that you have on your shin works hard to pull in opposition to the big calf muscle (yes, I am talking about your calves). Eventually the resulting muscle fatigue (from the tight calves) will cause you to absorb the pounding of running into the connective tissue and bone (as opposed to the muscle). Stretching options include:

• Kneeling position, the runner points his toes out behind and gently sits back on heels pressing the tops of the feet towards the ground.
• Standing arm’s length from the wall, place hands on wall, keep feet and knees straight, lean forward as far as possible.
• Standing with feet flat, bend knees forward as far as possible keeping heels on floor.

Soft Surfaces
As running on soft surfaces can alleviate early stage symptoms, head for the trail or treadmill.

Strengthening
Treatment alone will not alleviate your shin splints. Take the time to strengthen your shins as well.

• Have your partner hold your feet (which are flat on the ground) down. With resistance on your toes, lift them up slowly.
• Draw each letter of the alphabet with the big toe of each foot in the air.
• While standing erect raise up and down onto your toes several times. If that is too easy you can make it more challenging by performing the same exercise while standing on a step and allow your calves to stretch over the edge of the step.
• In a sitting position lower and raise the feet with the heels on the ground as high and quickly as possible for 60 seconds. I have athletes do this exercise during the school day while sitting at their desk.
• Walking on heels.
• Walking with feet turned inward and outward.
• Place your bare feet on top of a towel that is stretched out in front of you. Using you toes, slowly “gather up” the towel (i.e. pull it towards you) using only your toes.

Returning to Running
Depending on the severity of your shin splints, you may have to completely stop running for a period of time until you are pain free. If this is the case, take the time to cross-train (bike or swim). When you do get back to running, start slowly and almost exclusively on soft surfaces. Be sure to warm up for these early runs with some walking.

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