Shin Splints

[Deleted member 67185]

I saw that there was some interest in an older thread about shin splints, and thought perhaps re-posting something I had written previously might help with this issue. Especially now that folks are gearing up for the Spring pilgrimage season

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I put this together to provide help to those who wish to minimize the risk of the unpleasantness of shin splints while on Camino.

Warm Up -- ALWAYS warm up prior to exercise and stretch well after exercise.

• Walk at a slower pace at the beginning of each walk.
• Then perform ankle circles: rotate ankle ten times in one direction, then ten times in opposite direction.
• Next, do some toe points: point toes, then flex foot - ten times on each foot to get your muscles loosened up.
• Do the ankle circles and toes points several times each day or write the alphabet in the air with your toes.

After Walking

Stretch your calves, shins, and Achilles tendon after every walk. Tight muscles make the shin work harder to lift your foot.

When Walking

Choose a good walking surface. Avoid concrete if possible. If you walk on a road with an obvious camber, try walking out and back on the same side of the road to avoid putting too much stress on one leg.

1. Increase your mileage and speed gradually. The general rule of thumb is to increase mileage at a rate of 10% each week.
2. Be sure that you are not over striding.
   • Over striding occurs when you take longer steps to increase speed without running. Lengthen the stride in back, rather than in front, to improve power and efficiency in your stride. An overstriding walker has their front foot too far out in front of body. You want instead for your forward foot to contact the ground closer to your body.
   • Your stride should be longer behind your body, where your toe is pushing off, rather than out in front of your body. This is because your forward leg has no power, while your back leg is what is pushing you forward.
3. Be Aware of Your Step Rate
   • Increasing your cadence or step rate will significantly reduce impact forces. Focus on striking beneath your center of mass and avoid stepping out in front of your body—this will also prevent over striding and braking—to lessen the load placed on the tibia.

Perform Exercises to Strengthen Calves and Shins

Studies demonstrate that bigger and stronger calf muscles have a lower risk of developing tibial stress fractures. Since tibial stress fractures can be the result of shin splints that haven’t been addressed, it makes sense that strengthening your calves may also help walkers avoid medial tibial stress syndrome.

Consider the following strength exercises to help strengthen those calves and the surrounding muscles to help prevent shin splints:

Calf Raises

Standing with your feet slightly apart, raise up onto your toes, pause for 2 seconds, and lower back down. Complete two sets of 15 repetitions.

Toe Walks

Standing on your tiptoes, walk forward 15 yards. Complete two sets of 15 yards.

Foot Pumps

Lie down with your legs straight out in front of your body and your toes pointed toward the sky. In a pumping motion, point your toes back towards your body and then back to the original position. Complete two sets of 20 repetitions.

Heel Drop

Standing on a stair or elevated platform, put your weight on your right foot while lowering your right heel past 90 degrees. Slowly raise back up and repeat before switching sides. Complete two sets of 10 repetitions on each side.

If you have shin pain, you may need to take a day or two of rest and start back more slowly.

Remember: RICE -- Rest, Ice, Compression and Elevation. Ibuprofen is often recommended. There are health risks with this product. So, don't use without doing your own research.


BE AWARE -- There are a couple of related lower leg injuries which some folks may think are shin splints, but require medical intervention:

Compartment Syndrome

Pain on the lower anterior may be compartment syndrome, a swelling of the muscles within the compartment. Increased pressure compromises the area's circulation and function of the tissues in that space. Symptoms include pain, unusual nerve sensations, and muscle weakness. This condition requires a physician's diagnosis and surgical decompression may be necessary.

Stress Fracture

Another cause of pain in the lower leg is a stress fracture. If you have a definite spot of sharp pain when you run your hand along your shin the pain may be a stress fracture. A horizontal rather than vertical line of pain is another indicator and stress fractures normally feel better in the morning after a night of rest. A bone scan is necessary for diagnosis.

 

[JFG]

That is excellent information and one must also consider their foot alignment and it’s contribution to the development of shin splints. Feet that have an excessive or prolonged pronation phase (flat feet) stress the tibialis anterior muscle. It’s attachment on the lower leg is frequently the source of shin splint pain.
A combination of correct shoes and foot orthotics have also proven to be helpful. Expensive, custom orthotics aren’t always necessary. There are many good off the shelf inserts that are equally effective.

 

[Trude]

I saw that there was some interest in an older thread about shin splints, and thought perhaps re-posting something I had written previously might help with this issue. Especially now that folks are gearing up for the Spring pilgrimage season

---------------------------------------------------------------------------


I put this together to provide help to those who wish to minimize the risk of the unpleasantness of shin splints while on Camino.

Warm Up -- ALWAYS warm up prior to exercise and stretch well after exercise.

• Walk at a slower pace at the beginning of each walk.
• Then perform ankle circles: rotate ankle ten times in one direction, then ten times in opposite direction.
• Next, do some toe points: point toes, then flex foot - ten times on each foot to get your muscles loosened up.
• Do the ankle circles and toes points several times each day or write the alphabet in the air with your toes.

After Walking

Stretch your calves, shins, and Achilles tendon after every walk. Tight muscles make the shin work harder to lift your foot.

When Walking

Choose a good walking surface. Avoid concrete if possible. If you walk on a road with an obvious camber, try walking out and back on the same side of the road to avoid putting too much stress on one leg.

1. Increase your mileage and speed gradually. The general rule of thumb is to increase mileage at a rate of 10% each week.
2. Be sure that you are not over striding.
   • Over striding occurs when you take longer steps to increase speed without running. Lengthen the stride in back, rather than in front, to improve power and efficiency in your stride. An overstriding walker has their front foot too far out in front of body. You want instead for your forward foot to contact the ground closer to your body.
   • Your stride should be longer behind your body, where your toe is pushing off, rather than out in front of your body. This is because your forward leg has no power, while your back leg is what is pushing you forward.
3. Be Aware of Your Step Rate
   • Increasing your cadence or step rate will significantly reduce impact forces. Focus on striking beneath your center of mass and avoid stepping out in front of your body—this will also prevent over striding and braking—to lessen the load placed on the tibia.

Perform Exercises to Strengthen Calves and Shins

Studies demonstrate that bigger and stronger calf muscles have a lower risk of developing tibial stress fractures. Since tibial stress fractures can be the result of shin splints that haven’t been addressed, it makes sense that strengthening your calves may also help walkers avoid medial tibial stress syndrome.

Consider the following strength exercises to help strengthen those calves and the surrounding muscles to help prevent shin splints:

Calf Raises

Standing with your feet slightly apart, raise up onto your toes, pause for 2 seconds, and lower back down. Complete two sets of 15 repetitions.

Toe Walks

Standing on your tiptoes, walk forward 15 yards. Complete two sets of 15 yards.

Foot Pumps

Lie down with your legs straight out in front of your body and your toes pointed toward the sky. In a pumping motion, point your toes back towards your body and then back to the original position. Complete two sets of 20 repetitions.

Heel Drop

Standing on a stair or elevated platform, put your weight on your right foot while lowering your right heel past 90 degrees. Slowly raise back up and repeat before switching sides. Complete two sets of 10 repetitions on each side.

If you have shin pain, you may need to take a day or two of rest and start back more slowly.

Remember: RICE -- Rest, Ice, Compression and Elevation. Ibuprofen is often recommended. There are health risks with this product. So, don't use without doing your own research.


BE AWARE -- There are a couple of related lower leg injuries which some folks may think are shin splints, but require medical intervention:

Compartment Syndrome

Pain on the lower anterior may be compartment syndrome, a swelling of the muscles within the compartment. Increased pressure compromises the area's circulation and function of the tissues in that space. Symptoms include pain, unusual nerve sensations, and muscle weakness. This condition requires a physician's diagnosis and surgical decompression may be necessary.

Stress Fracture

Another cause of pain in the lower leg is a stress fracture. If you have a definite spot of sharp pain when you run your hand along your shin the pain may be a stress fracture. A horizontal rather than vertical line of pain is another indicator and stress fractures normally feel better in the morning after a night of rest. A bone scan is necessary for diagnosis.

I find wearing compression tights totally prevents it.
For me anyway. I lent my tights to someone who was experiencing it and it helped immediately.

 

[Deleted member 67185]

I find wearing compression tights totally prevents it.
For me anyway. I lent my tights to someone who was experiencing it and it helped immediately.

Compression can be of partial benefit, but that benefit is varied and there is much clinical disagreement as to what kind of benefit that might be, and to what extent that benefit would be. Part of the problem is that "Shin Splints" is a specific diagnosis, whereas non-professionals use the term 'shin splints' tend to use the term in generic fashion to label any discomfort at the fore part of the lower leg.

So no, as a specific tool, compression will not, in general, prevent shin splints. The mechanics of what causes shin splints does not lend itself to compression as a preventative.

Compression CAN assist with the discomfort from swelling as a palliative during exercise. It is a primary component - when one is finished walking or running- to use for treatment during rest phases. Compression, together with ice and elevation, and depending of the stage and severity of the shin splint, heat therapy.

So I gently say that I disagree that wearing compression tubes or sleeves or stockings, etc, will prevent shin splints from occurring.

 

[Deleted member 67185]

That is excellent information and one must also consider their foot alignment and it’s contribution to the development of shin splints. Feet that have an excessive or prolonged pronation phase (flat feet) stress the tibialis anterior muscle. It’s attachment on the lower leg is frequently the source of shin splint pain.
A combination of correct shoes and foot orthotics have also proven to be helpful. Expensive, custom orthotics aren’t always necessary. There are many good off the shelf inserts that are equally effective.

You are correct in that a pronounced pronation can be causative, and I have discussed this elsewhere, so I appreciate your addition.

I have also recently posted a thread with information about orthotics vs inserts. You are correct that orthotics are not always needed, and I would suggest that for most pronation or motion control issues, are wasted money. There are a lot of great shoes that incorporate pronation correction into the shoes, and with a broad range of third party insoles and inserts, most folks can deal with mild to moderate pronation on their own.

If there is any concern, then have things assessed by a Podiatrist who specializes in sports and athletics, rather than a general practice Orthopedist.