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Training

Help with Shin Splints and how to beat them

The clinical name for shin splints is Medial Tibial Stress Syndrome (MTSS) and is defined by the American Academy of Orthopaedic Surgeons as "pain along the inner edge of the shinbone (tibia)." Shin splints are characterised by general pain in the lower leg, specifically between the knee and ankle on the medial, or inner edge of the shin. Pain on the lateral (outside) side of the shin tends not to be associated with shin splints. The most likely cause, as with most injuries is repeated trauma to the area around the tibia.

Causes of Shin Splints

Repeated stress or trauma is the most likely cause of shin splints. Although the exact cause is unknown, it is typically thought to be caused by weakness or inflexibility in the muscles of the lower leg, especially the gastrocnemius and the soleus muscles which results in the tibia having to absorb impact forces.

Shin splints can be caused by excessive overloading of the tibia through increased intensity or frequency of an activity, particularly activities involving lots of running or jumping. This can lead to stress fractures in the shin bone. It can also be caused by a change in the surface such as a move from grass and dirt to concrete. These contribute to shin pain because a change in stimulus such as increased intensity causes muscles to fatigue faster, and fatigued muscles cannot absorb as much of the impact force. It is also thought that overpronation may cause shin splints as excessive rolling can further put pressure on the shin bone. When any of these happen it is thought that the connective tissue that covers the surface of the tibia (periosteum) becomes inflamed.

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Symptoms

Pain has been described from a dull ache to intense pain that increases during exercise. Some individuals can experience swelling in this area. It is important that if you suffer pain along the side of the shin that you stop running. If you run through the pain, you could cause further damage, so it is important to stop - if possible of course - at the first sign of pain.

Treatment and Prevention

As the exact cause of shin splints is unknown, treatment isn't always successful. Nevertheless, as with most injuries the best way to treat shin splints is with rest and ice. Rest allows the muscles to recover and ice reduces pain and inflammation. You should apply an ice pack for 15-20 minutes every 2-3 hours during the first few days of rest, after this time the pain and inflammation should subside. If not continue for another couple of days and if pain still persists, it would be advisable to consult your GP or doctor as there may be some underlying issues such as poor circulation, muscle hernia, compartment syndrome or nerve problems.

If pain is reduced, the next step is to strengthen and stretch the calves and front of the leg. Below is a good stretch for the front of the calves.

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As with most stretches, hold for 30-60 seconds and repeat 2-3 times daily. Calf stretches and raises are also necessary in shin splint rehabilitation and prevention.

In terms of prevention, you can also consider looking at your running shoes. As the most accepted cause of shin splints is the tibia absorbing impact forces, to reduce this, a pair of shoes with adequate support and cushioning may help reduce these forces. Furthermore, compressive elements such as compression socks or calf sleeves are also thought to help as they prevent micro-vibrations in the lower leg muscles which can contribute to muscle fatigue.

As with any injury, you have to be patient with rehabilitation. Take your time to get back into training, if it was a sudden increase in intensity that caused your shin pain then take a step back. Similarly, if it was a change from grass to concrete that caused pain, go back to grass and work road running slowly into your regimen.

Written by Harrison Foster

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