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Things to Do to Help Prevent Shin Splints

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[MODERATOR NOTE: See this thread for an update to this post.]

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

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.
 
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Thank you, Doc.
"Mens [et anima!] sana in corpore sano"!
Your precious suggestions can greatly help pilgrims to never walk "mourning and weeping in this valley of tears".
 
Thanks for this. I developed shin splints on Day 37 of my camino (when I had thought myself to be 'invincible' after having no physical problems at all up to that point), and it was quite painful for a day or two. Thankfully I was near the end anyway and they quickly healed.
 
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Thanks Dave. Great information.
Last time at the Physio I was asking about this, and at the Podiatrist.
I was getting severe shin pain just above the foot. (low on the Shin)

Physio thought it was not shin splints in my case, but muscular. Must ask him to explain again.
The podiatrist reckoned it was caused by the foot 'flopping' down or 'slapping' down on the forward step.

Which fits with your description above. Over striding, particularly down hill.

But he indicated it could not be avoided or prevented!
I think your advice is more sound.........

I would rather walk 800 kms again with Achilles Tendonitis, which I have learned to manage, that shin pain.
I had severe shin pain on the last 120 kms and it was not pleasant at all.
No amount of painkillers, icing or anything else seemed to help.......

I will make sure to heed your preventative steps !
 
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Timely note. I just attended a lecture on the biomechanics of the foot and the resulting issues with poor foot strength and foot “posture” while walking. All the above points and recommendations were seconded by the biomechanist. The result of not strengthening your feet correctly, includes shin splints, knee pain and hip issues.

I was the guinea pig and could not believe what some simple foot work did for my balance, flexibility and pain in one short hour. I plan on spending a bit more time with the biomechanist in getting ready for my camino in September. Might have to learn to walk properly.
 
I'm saving this for my next Camino. I developed a shin splint after experimenting with taking longer strides to "speed up" a little. Wow, what a mistake, but I sure learned that lesson.
 
Hi Dave
Valuable advice. I would like to add that my research also attributes shin splints to dehydration. When the body does not have enough fluid it robs areas not vital to survival which includes joints and the fascia around muscle bundles and tendons. The fascia is primarily collagen. The fascia when dry becomes brittle hence shin splints. Having had them I certainly know how painful they are. Now drink a lot of water before starting and add electrolytes in warm to hot weather to aid fluid retention.
More on this in Chapter 5 of “Backpacks, Boots & Blisters” which focuses on getting Camino Ready.
Regards
Mark
 
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Not wishing to be defeatist here........ :rolleyes:

But if shin pain occurs, has anyone found a suitable treatment?
I tried pain killers, anti inflammatories, icing, taping........
Nothing really helped. :(
 
What are the best stretches for the Achilles tendon? I have recently started getting some pain on the back of my heel. At first, I thought it was a hot spot (it had that "burning" feeling) -- but it wasn't. I'm pretty convinced my Achilles tendons are angry with me for walking several miles every day. They especially don't like going uphill. I did read that over-striding can cause Achilles issues (and I've got short little legs, so when I hike or walk with others, I'm constantly trying to keep up). I've made an effort to walk more at my pace and that does seem to help some -- but I want to avoid future problems (especially on the Camino).
 
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What are the best stretches for the Achilles tendon? I have recently started getting some pain on the back of my heel. At first, I thought it was a hot spot (it had that "burning" feeling) -- but it wasn't. I'm pretty convinced my Achilles tendons are angry with me for walking several miles every day. They especially don't like going uphill. I did read that over-striding can cause Achilles issues (and I've got short little legs, so when I hike or walk with others, I'm constantly trying to keep up). I've made an effort to walk more at my pace and that does seem to help some -- but I want to avoid future problems (especially on the Camino).

The short of it is that Achilles tendinitis is an overuse injury. However, there are some factors besides simple use which can affect that tendon.

Any use of medications with fluoroquinolones (broad spectrum antibiotics, commonly used for UTIs)?

Are the back of your shoes rubbing against the tendon? If so, that could be the cause. A lot of shoes have the heel deeply cupped, forcing the heel way back into the back of the shoe. Combined with a thick padding on the back collar, the collar of the shoes can press into the achilles which will inflame it. I saw this a lot as a field combat medic in the Army. Frequently, gluing a 'T-strap' -- which was made of a cushioning felt -- vertically along the back of the boot, would mitigate the boots pressure on the Achilles.

Modifying the shoe by padding the heel cup to reduce the pressure, or even doing some surgery on the shoe to lower the back so that it removes the point of contact, will help tremendously if that is the issue.

When the cause of the tendonitis is determined and rectified, treatment using an alternating ice, then heat, then ice (20 minutes, 10 minutes, 20 minutes) will help. We used to dispense a wintergreen oil/astringent that provided relief when used topically. If not contraindicated, ibuprofen will help reduce the selling. Once the pressure is off the achilles, a lot of relief will occur within 24 hours, and you'll wonder where the tendonitis went within 48-72 hours.

If there is aggressive swelling, and severe tenderness and pain, that is a sign that achilles can be in danger of longer term damage or even a rupture. It is also a sign that there might be a partial tear. A doctor needs to be consulted for a differential diagnosis to determine what course of treatment should be followed.
 
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Not wishing to be defeatist here........ :rolleyes:
But if shin pain occurs, has anyone found a suitable treatment?
I tried pain killers, anti inflammatories, icing, taping........
Nothing really helped. :(
Two traditional Italian natural remedies for inflammation to joint, muscle and fascia - also well known in Spain - are very effective:
1) poultice of clay
2) leaves of cabbage.
Of course, "Rome wasn't built in one day", but these two cheap and with no side effects things were resolutive for me and the many other kayak athletes that I used to coach.

See in attachment a text that I put together for English speaking friends.
 

Attachments

  • Italian Traditional Remedies (Clay, Cabbage, Magnesium Chloride).pdf
    86.6 KB · Views: 22
I put this together to provide help to those who wish to minimize the risk of the unpleasantness of shin splints while on Camino. :D:eek:

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.
Great article. Thank you. I got a tibial plate fx once! Susu60
 
St James' Way - Self-guided 4-7 day Walking Packages, Reading to Southampton, 110 kms
I put this together to provide help to those who wish to minimize the risk of the unpleasantness of shin splints while on Camino. :D:eek:

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.
 
Excellent, I suffered a shin splint on the last week of my six week walk last year. Rock Tape and Ibuprofen got there. I will read your advice a bit closer at my leisure as I am doing the full Camino again later this year.
 
I put this together to provide help to those who wish to minimize the risk of the unpleasantness of shin splints while on Camino. :D:eek:

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.


One thing I have found over many miles of walking is to alter the gait as soon as you feel you might be developing shin splint. Raise your knee on each stride and slow down, just for 30 or 40 strides. those following might think you have taken leave of your senses but I have nipped the shim problem in the bud this way.
 
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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. :D:eek:

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.
Dave!!!!

Great instruction. I do have a question on something not covered, IT Band Syndrome. This hit me late Aug/16 between Espinal and Viskarrat and ended my Camino. Only recently, I have received physio care and it is getting better now but this one, once injured, can hold onto you for a very long time.

Any thoughts?
 
Two traditional Italian natural remedies for inflammation to joint, muscle and fascia - also well known in Spain - are very effective:
1) poultice of clay
2) leaves of cabbage.
Of course, "Rome wasn't built in one day", but these two cheap and with no side effects things were resolutive for me and the many other kayak athletes that I used to coach.

See in attachment a text that I put together for English speaking friends.

When I was a student midwife we kept cabbage leaves in the fridge at the hospital. Used for engorgment. The relief, as I found when I used it, is instantaneous. I have also subsequently used it for ankle swelling
 
Dave!!!!

Great instruction. I do have a question on something not covered, IT Band Syndrome. This hit me late Aug/16 between Espinal and Viskarrat and ended my Camino. Only recently, I have received physio care and it is getting better now but this one, once injured, can hold onto you for a very long time.

Any thoughts?

Where are you at in your recovery phase, Michelle? Are you just doing passive physical therapy, or are you recovered enough to be doing remedial, active stretching and strengthening exercises?

Certifiable and commonsense legal note which is what any sane person already realizes. Heed this for your own sake :p;):D . You are more than aware that your therapist and Dr are the only ones in a position to properly assess you, and that all I am capable of doing is offering some general observations. I do have significant university level course work in anatomy and physiology as it applies to exercise and sports, and some clinical experience, but other than keeping up with the Journals, I am not in a client practice. :)

Whew, glad to clear that up for anyone who is concerned. ;)

Again, I am happy to offer general observations and perhaps provide something to ask your therapist about, but your medical team is the primary guidance.
 
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A selection of Camino Jewellery
What are the best stretches for the Achilles tendon? I have recently started getting some pain on the back of my heel. At first, I thought it was a hot spot (it had that "burning" feeling) -- but it wasn't. I'm pretty convinced my Achilles tendons are angry with me for walking several miles every day. They especially don't like going uphill. I did read that over-striding can cause Achilles issues (and I've got short little legs, so when I hike or walk with others, I'm constantly trying to keep up). I've made an effort to walk more at my pace and that does seem to help some -- but I want to avoid future problems (especially on the Camino).

I had / have bursitis at the back of the foot Janade , though i swear my archilles are sore the first step in the morning .
Two minutes later all is well ,
We simple now *walk slower **keep the day to under 20km *** the bags go ahead if hills are involved and the most important for me anyway is *******Ecco and or Merrell Sandal's.
Strap on the back helps , 80% with merino wooden socks and a bit of vasaline and all has been well for the last few years .
 
I put this together to provide help to those who wish to minimize the risk of the unpleasantness of shin splints while on Camino. :D:eek:

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.
when i walked the camino first I had severe shin splints. I tried iboprufen but this did not help and may have exacerbated the condition because it dilates blood vessels. I found small frequent doses of alcohol - agua dienthe in coffee, a glass of wine at lunch - worked best
 
when i walked the camino first I had severe shin splints. I tried iboprufen but this did not help and may have exacerbated the condition because it dilates blood vessels. I found small frequent doses of alcohol - agua dienthe in coffee, a glass of wine at lunch - worked best

John, you are correct in that ibuprofen can allow a relaxation of vessels which can allow more blood flow. The question is: is increased blood flow an issue with shin splints?

Not so much. In fact, it can be helpful.

The problem in shin splints, as with many muscle injuries, is the production of prostaglandins. . , substances that the body releases in response to illness and injury. It is prostaglandins which create the inflammation that needs to be controlled. Ibuprofen works by blocking prostaglandin production.

When using ice for shin splint therapy, it is not meant for specifically reducing blood flow, but to help with the process of inflammation. Even more to the point, some increase in blood flow can assist and help with healing by increasing removal of waste and increasing oxygen and nutrients to the muscles.

As with all medications and therapeutics, not everyone will be helped when taking them. Although it might not decrease the level of discomfort and aggravation to the injury, it could very well help to control increased aggravation of the injury from continuing to escalate.

And it won't hurt to stick to reasonable ethanol ingestion in any case :).
 
The focus is on reducing the risk of failure through being well prepared. 2nd ed.
  1. Be sure that you are not over striding. Lengthen the stride in back, rather than in front, to improve power and efficiency in your stride.
"Lengthen the stride in back, rather than in front..."
Interesting.. Reminds me of the old movie theater joke, "Hey, sit down in front!"
"I don't bend that way."
 
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Not wishing to be defeatist here........ :rolleyes:

But if shin pain occurs, has anyone found a suitable treatment?
I tried pain killers, anti inflammatories, icing, taping........
Nothing really helped. :(
I had painful shin splints. Iboprufen is the worst thing you can do I learnt because it further constricts blood flow. I had some relief but not cure from a glass of wine or agua dienthe in my coffee or a beer whenever I stopped. I understand alcohol dilates blood vessels. worked for me
 
I had painful shin splints. Iboprufen is the worst thing you can do I learnt because it further constricts blood flow. I had some relief but not cure from a glass of wine or agua dienthe in my coffee or a beer whenever I stopped. I understand alcohol dilates blood vessels. worked for me

On my last Camino I took a physio roller.
No shin splints!

This one, Though I cut it shorter.
This is my physio Pete demonstrating how to use it.

 
Very light, comfortable and compressible poncho. Specially designed for protection against water for any activity.

Our Atmospheric H30 poncho offers lightness and waterproofness. Easily compressible and made with our Waterproof fabric, its heat-sealed interior seams guarantee its waterproofness. Includes carrying bag.

€60,-
Ever since having very painful shin splints on one of my early Caminos I have used Skins brand calf compression sleeves every day while walking and no more shin splints.
 
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