Shin Splints - Overuse or Biomechanical?

Most runners at some point in their career experience pain in the calf or shin. If you are a new runner,  experiencing this pain can be discouraging especially at the beginning of a training season.  Shin splints are amoung the top 5 running injuries, and if you have shin splints, put the discouragement aside and instead use this as an opportunity to learn what caused the shin splints and how to treat them. The knowledge you gain will make you a better runner.

Shin splints can be mild to sever, with stress fractures being a common result of sever shin splints not being treated effectively. Understanding the circumstances that lead to these injuries is the key to preventing them. Shin splints develop along the tibia bone. The usual location is along the lower half of the tibia, anywhere from a few inches above the ankle to about half-way up. For runners starting to run too much too soon, or runners who are over-striding or have old worn-out shoes, the running cycle results in muscle fatigue along the tibia. The severity of this injury increases as  continuous forces are applied to the fascia, the attachment of fascia to bone, and finally the bone itself. This is a key reason we recommend that you seek the attention of your coach and doctor as soon as you have shin splints (or any injury).

By the time you have a diagnosis of shin splints, we recommend that you have stopped running and start immediately with determining the cause and solution. If you act quickly, you can know the cause and solution by the time your injury heals. If you delay correct identification of the problem or proper treatment, your experience with shin splints could be a long, drawn out ordeal. Many new runners drop out from running altogether because of this very treatable condition.

Once you have been diagnosed with shin splints, the best thing to do is identify the problem. Be sure to take a look as these three possible causes:

   a)  too much too soon: did you go too fast or too long? If so, work with your coach to make corrections.
   b)  shoes: do your shoes need replacing?
   c)  over-striding: a commonly overlooked cause of shin splints, especially with new to runners.
         Go slower by shortening your stride-length.

Stop Running
The best case scenario is that you’ll need to stop running for as long as it takes for the pain to go away. You should be able to walk during this stage, and at some point, the pain must go away while walking. While you have stopped running,  determine the problem (what caused the painful symptoms?) and what you’re planning on doing about the problem.

Correct the Problem
If the problem is “too much too soon” then slow down and shorten your distances. Work with your coach to reassess your goals and get you on a suitable path. Cross training and development of core strength can go a long ways to preventing a myriad of injuries including shin splints. Your coaches already know you can go the distance if you training sensibly.

Recover from the Injury
The time it takes for your body to heal itself has many influences, including the use of Non-steroidal anti-inflammatory drugs (NSAIDs such as aspirin and ibuprofen), icing protocols, proper nutrition, hydration, rest and reduction of stress on the injury. Discuss with your doctor and coach how to have a rapid recovery from shin splits, and use this time to identify the problem and suitable treatment.

Gradually return to running
Once the problem has been identified, and a treatment plan created, and your muscles and fascia have recovered (pain-free) then you can gradually return to running. And the good news… you have learned a great deal about injuries that will make you a better runner!

More on Shoes
Distance running shoes are specifically designed to provide padding and support for the biomechanics of endurance running. They help absorb shock and facilitate efficient energy (motion) transfer. Matching the type of running shoe to the athlete’s specific biomechanics, and proper shoe fit are important. Similarly, worn out shoes should be replaced early because of reduced shock absorbing capacity. Runners with high rigid arches tend to experience greater pounding shock, whereas those with flat feet tend to experience greater fatigue of the muscles that support the foot -- and push-off. Both tend to develop shin splints

Early Stage Shin Splints
In the early stage of shin splints a runner will describe a pain that is present when the training run first begins, but then disappears as running continues. The pain will often return after exercise or the following morning. As the injury progresses the athlete will experience more time with the pain, and less time without it. There is frequently a tender zone along the medial edge of the tibia that one can map out by pressing with the fingertips as they “march up” along the bone. Eventually, if ignored and training continued, the pain may become quite sharp and may focus on a very small area of the bone. If this happens a stress fracture should be considered.

More on Treatment
The treatment for shin splints is rest. Depending upon severity it is often necessary to completely stop running for a period of time. Generally this is done until day-to-day activities are pain free. When running is resumed – and this is where many injured runners make a mistake – it must be significantly different from the routine that lead to the injury. The concept of relative rest employs lengthening the interval between training as well as decreasing the volume and intensity of training. One can often substitute cross-training activities (e.g., bicycling) for running to help increase the interval between running days. There should be a graded and gradual increase in run training, keeping an eye out for the return of any shin splint symptoms.

Stretching and strengthening the calf muscles can help prevent the injury from returning. However the most important preventive strategy is not to repeat the mistakes that lead to the injury. Examine all the training variables – surface, shoes, training volume, intensity, workout type, hills, biomechanics, etc.  Seek help from a qualified trainer or coach. This all takes time and effort, but it is well worth it.



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