Shin Splints: Causes, Prevention and Recovery

By: Melinda Burris Willms

      Shin splints, or to use the full medical term, medial tibial stress syndrome (MTSS), are a source of frequent complaints among athletes. Classified as an overuse injury, shin splints cause pain and swelling  along the front and outside of the shinbone. According to a 2012 case study published in the International Journal of Sports Physical Therapy, “The sports in which athletes are most commonly afflicted are cross-country, track, basketball, and volleyball.” The repetitive motion running requires puts long-distance runners at particular risk for developing shin splints. The study found that up to 16.8% of long-distance runners may experience medial shin pain (Loudon & Reiman, 2012). (And shin splints are perhaps the most common overuse injury among hurdlers due to the push-off with the trail leg and the impact of landing on the lead leg. -Coach McGill).
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What Exactly Are Shin Splints?

Shin splints occur when an inordinate amount of stress is placed on the shinbone and the connective tissues between the bone and muscles. This stress causes painful swelling at the shin and the surrounding area. There are a number of contributing factors that can put you at increased risk for developing shin splints, but the most frequent cause is excessive repetition of movement overexerting the soft tissue around the shin.

Other Causes of Shin Splints

1. Fallen arches (commonly called flat feet) place more pressure on the shins and can cause splints.
2. Make sure your running shoes are the proper size and provide you with adequate support! Ill-fitting shoes cause improper weight distribution which can lead to shin splints.

Practicing preventative measures is important, not only to avoid pain and injury, but also to guard against diminished performance. In their 2012 case study, Loudon and Reiman observed that shin splints affected the ability to run in numerous ways, including: diminished knee flexion, increased hip internal rotation (increased pressure placed on the hips as the body attempts to compensate for weakened shins), and a rise in the need for physical therapy.

Preventing Shin Splints

Coach Erin Truslow specializes in endurance sports training and has over three decades of experience. Truslow recommends the following preventative measures to protect against developing shin splints:

1. Increases in running distance should be undertaken gradually, allowing your body to adjust to intensified exercise. (For hurdlers, this would apply to hurdling volume, particularly in the off-season, when volume is emphasized. -Coach McGill).
2. If possible, change up the surface you run on. Different terrains put varying amounts of stress upon the shins. (For hurdlers, this means never hurdle on a concrete track, and even a mondo track can be very hard on the shins. Rubberized surfaces are the best. If your team trains on a concrete track, try to do as much of your hurdling on the grass as possible. -Coach McGill).
3. You also need to change up your workout routine. Regular variation in your exercise routine avoids repetitive motion injuries and also ensures you are getting a full body workout.
4. Coach Truslow emphasizes the importance of cross-training to strengthen the legs.
5. Truslow also recommends paying close attention to your foot strike, ideally aiming for a mid-foot strike, in order to achieve an “efficient run” (Lauretta, 2017). (For hurdlers, this means to always keep your ankles dorsi-flexed to ensure that you are running on the balls of your feet, and that each foot strike is landing directly beneath the hip. If your ankles are plantar-flexed, with the toes pointing down, you will increase the risk of shin splints, as your shins are absorbing most of the impact. -Coach McGill).
6.  Be sure to warm up and stretch your muscles adequately before you run. It is also important to complete a proper cool down routine.

Treating Shin Splints

This condition can often be self-treated with common sense measures:

1. Listen to your body; rest and give the injury a chance to heal.
2. Applying ice packs to the shin will alleviate painful swelling. This should be done every 3-4 hours, for 20-30 minutes, over a period of 2-3 days or until the pain has resolved.
3. Be sure to wear shoes with the appropriate insoles/orthotics.
4. Non-steroidal anti-inflammatory drugs (NSAIDs), which include over-the-counter medications such as ibuprofen and aspirin, have been shown to effectively alleviate pain and swelling.

*While shin splints frequently resolve with these self-care measures, be sure to consult your doctor if you experience no relief from the above treatment strategies or if the problem persists.*

Writer and runner Brent Rose (2012) suggests the following exercise to treat shin splints:

1. Stand on a stair or curb.
2. Position yourself so that you are looking down at the stair or curb. Move your foot forward until only your heels rest on the stair/curb and allow the front of your feet to hang off the edge. (Make sure you maintain balance, lean against a wall or tree if you need additional support.)
3. Keep your legs straight while you point your toes as far downward as possible, then lift the toes quickly and extend them as far as possible. Repeat.
4. Time yourself and repeat this lower and lift exercise as often as possible for 30 seconds. Rose emphasizes the importance of completing the lower and lift movements as quickly as you can, extending and flexing as completely as possible.
5. When the 30 seconds are up, “bend your knees at a 45-degree angle” and proceed to do an additional 30 seconds of pointing and flexing with your knee bent.
6. After a brief rest, do a second set—”30 seconds with the legs straight, immediately followed by 30 seconds with the knees bent” (Rose, 2012). Repeat the set a third time.
7. Do this exercise 3 times a day.

Is KT Tape an Effective Treatment?

Due to the fact that shin splints are most frequently caused by putting too much stress on the shinbone, some in the running community have suggested that using kinesiology tape could assist in the prevention of shin splints under the theory that the tape can facilitate the body coping with the increased demands running longer distances requires (Groom, 2014). You may want to try taping to see if it helps you, but keep in mind that as discussed in last month’s article, no scientific studies have found proof that kinesiology tape has any value. Research to date does suggest that responses to taping are highly individualized; it works better for some than others, leading medical experts to question whether performance gains seen through taping are an example of the placebo effect. A research study conducted just last year investigated this very issue.  In their case study, “Comparison of Effectiveness of Kinesio Taping with Nonelastic Taping and No Taping in Players with Acute Shin Splints,” Sharma and Sinha (2017) found that participants using kinesiology tape showed no demonstrable improvement in comparison to participants using traditional athletic tape or no taping at all.

References

Groom, T. (22 July, 2014). Kinesio Tape for ‘Shin Splints’?.

Lauretta, A. (30 August, 2017). 6 Simple Exercises to Prevent Shin Splints

Loudon, J.K. & Reiman, M.P. (2012). Lower Extremity Kinematics in Running Athletes With     and Without A History of Medial Shin Pain

Rose, B. (18 April, 2012). Banish Shin Splints Forever With One Magical Exercise

Sharma, B.B., et al. (2017). Fredericson Type III Medial Tibial Stress Syndrome (Shin Splints):   A Case Report.

Sharma, U. & Sinha A.G. (2017). Comparison of Effectiveness of Kinesio Taping with     Nonelastic Taping and No Taping in Players with Acute Shin Splints

TrainingPeaks. Erin Truslow Biography

WebMd. (13 December, 2017). Shin Splints Symptoms, Treatment, Recovery, and Prevention

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