Healing & Preventing Shin Splints

Dr. Mark Greenberg, M.Dd
All-Star Orthopaedics

SHIN SPLINTS

Causes, treatment & prevention

Shin splints, the term itself does not constitute a diagnosis, instead it encompasses a number or disorders that present as mild swelling, soreness or pain along or just behind the inner edge of the tibia, which typically increases with activity.

Historically, the causes of shin splints have been attributed to everything from running on uneven surfaces to rapid increase in activity, biomechanical malfunctions, which can include over pronation due to ankle inflexibility or overuse / inflexibility of the gastroc or soleus can often be the true cause of shin splints.

Risk Factors for shin splints include:

  • Overpronation
  • Inadequate arch support or worn out shoes
  • Overuse
  • Tightness or weakness in the calf (Gastrocnemius and soleus), Achilles tendon or ankle, or plantar fascia

Overpronation
During a normal stride, the foot’s first function is to absorb and help dispel shock from impact. This is followed by pronation (rotation inward and downward) so that the foot can manage the terrain. The ankle then flexes, allowing the knee to move forward, while the heel raises, and the foot supinates allowing for the pushing action that eventually ends with the toe-off.

Overpronation can be caused a by poorly supported arches, tightness in the ankle, Achiles tendon, calf or other muscle imbalances. Without proper arch support the foot lands, flattens out and the ankle overpronates. The tibia is then forced to twist slightly in the outward direction pulling the calf muscles with it. This overpronation delivers inferior stabilization and inefficient shock absorption. Over time, this repetitive, inefficient motion creates “shin splints”.

Calf flexibility also plays an important role in preventing and remedying shin splints. Flexible calf muscles will provide more “give” in support of this motion, however, one of the most effective things an athlete can do is to stop the foot from rolling. This can be done by both strengthening the muscles and tendons which support the ankle and with proper arch support in both athletic and every day shoes.

Shin Splint Prevention
It is critical to rule out stress fractures or other more serious causes for the shin pain. Shin splints can be easy to remedy but trying to “play through the pain” is likely to make the injury worse. Athletes must also play a role in their treatment on and off of the field. Worn out or ill-fitting shoes or shoes without proper arch support (flip flops, sandals, casual shoes) will exacerbate the problem. When treating shin splints, employing rest, ice, non-weightbearing exercises and adequate stretching and massage should be the first line of defense.

Support Arches & Increase Shock Absorption
After rest and ice, arch supports can play a big role in providing immediate relief for shin splints. Proper support helps cushion and disperse stress on your shinbones as well as guide proper pronation.

Promote Circulation
Athletes often find relief from light compression. Compression applies gentle support for lower legs while promoting circulation and warmth which in turn controls fluid build-up and enhances healing.

Stretch & Strengthen
Gastroc and soleus flexibility is imperative to the health of shins. By stretching calves daily and increasing calf flexibility, the risk of injury can be reduced. Gastroc and soleus flexibility play an important role in maintaining ankle flexibility and reducing the risk of Achilles tendon tightness.

Massage
Finally, trigger points can also cause the tibialis anterior to be weaker than normal, putting extra stress on the connective muscle fibers. Massaging can bring added relief and flexibility. For increased circulation and performance consider massaging the lateral head of the gastroc, back mid-calf at the muscle/tendon juncture, posterior tibialis and the lower leg along the sides of the tibia.

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