Shin Splints are one of the most common injuries we see among our athletes, and they can be extremely painful! They are a problem that we must be aware of all the time. In this article I’d like to talk about the causes, prevention and treatment of this debilitating injury.
CAUSES
There are a lot of different theories about what causes shin splints. Some people say they come from running on hard surfaces or from “toeing out” at the end of the stride. Most likely they are related to wearing worn-out shoes or (commonly in middle school athletes) to a change in mileage or in intensity while training. My personal belief is that most of the cases we see are caused by a too-rapid change in training: either adding mileage too fast or in changing from running slow miles to running intense intervals. Unfortunately, our short cross-country and track seasons make it difficult to break into training gradually. Therefore we believe that it is imperative that athletes practice preventive measures regularly.
PREVENTION
Obviously if shin splints are primarily caused by overtraining, it is important to pay attention both to the training schedule and to your body. Remember that the schedule that works for your teammate may not be the best one for you. Be sure your coach knows if you are having trouble recovering from your training runs, or if you have extreme fatigue in your lower leg.
It is also very important to pay attention to the mileage on your shoes. Remember to use your running shoes only for running—that way you can keep track of how many miles you have on them and can replace them when they have 200-300 miles logged. They will usually still look perfectly good at this point but they still need to be replaced! Shoes are your most important piece of equipment.
There are some exercises you can do that we have found to be very successful at preventing shin splints. You need to increase the flexibility and strength in your lower leg, especially at the front of the leg. You can sit in a chair with your knees bent 90 degrees and your feet flat on the ground. Then lift your forefoot, keeping your heel on the floor. Raise it up as far as you can without being uncomfortable, then lower it back to the floor. Repeat this 10 times with each foot, and do this at least once a day. You can do a similar exercise while lying on your back. With your leg extended, move your toes back towards your head, then point your toes. Again, do this 10 times with each foot. Another good strengthening exercise is to stand on the edge of a stair or a curb. Just stand on the balls of your feet with your heels hanging over the edge. Then raise your heels slowly and then lower them a little lower than your starting position. However, be careful with this one as it puts a great deal of stress on your tendons. If it hurts, back off!
We have had great luck with a balancing exercise that we do during warm-ups. To do this exercise stand on one foot, close your eyes, and try to balance. The idea is that all the little muscles in your lower leg have to do the work to keep you balanced, so this strengthens them. Do this every day on both legs. We have noticed a dramatic difference in the number of shin splint problems our athletes have had since we added this exercise to our warm-up routine.
TREATMENT
If you are like most people, you probably skipped the first part of the article and came straight to this section because you already have shin splints and now you want to know what to do about them. This is unfortunate, because ultimately there’s not a great deal that can be done once you have them. The best time to take action is before shin splints happen! However, there are some things you can do that might give you some relief.
First you need to know that the recommendation for shin splints is ALWAYS to rest them. It is almost impossible to heal them while you are still training. In reality, though, I think it’s a good idea to get the coach, athlete, and parent together to discuss how to handle the injury. It may be that there’s only a week or two left in the season and you might decide to gut it out with the help of ice and ibuprofen. I’m not suggesting this but I think it’s a possibility if the coach and athlete are both knowledgeable about shin splints and if the coach is informed on a daily basis of the athlete’s status. The workouts must be modified and the athlete must be monitored closely. The reason I mention this possibility is because it is really important for athletes to keep their coaches aware of any problems they might be having. Don’t keep things like pain in your shin from your coach just because you think he might make you stop running!
Ice and ibuprofen, mentioned above, are always recommended for shin splints. The best way to ice your shins is to do ice massage. You can make an ice massage cup by filling a paper cup three-quarters of the way full with water, then freezing it. To use, tear off the top of the cup and use the bottom for a handle. Rub the ice on your shins for a few minutes (use a towel under your leg or you’ll make a mess) until it starts to hurt from the cold. Rest it for a couple minutes then continue with the icing. Ice like this for 10 minutes 2 or three times a day. I recommend continuing this treatment for a week or two after you think the shin splints are healed.
Some people get some relief from shin splints by using a little heel lift in their shoe. Start small—you don’t want to lift your heel too drastically or you might cause some other issues.
I know that some coaches tape athletes extensively so they can still do their workout when they have shin splints. I happen to disagree with that treatment simply because if the pain is so bad that the athlete is having to tape in addition to icing and ibuprofen, it’s time to re-evaluate. Pain occurs because your body is trying to tell you something! It’s a good idea to listen.