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Personal Experiences
When I first started running, well at least attempting to run, I was tipping the scales at a chunky 300 pounds. I am fairly tall (6'2"), however I was still carrying around about a hundred pounds more than I should have been. This fact, combined with my rabid enthusiasm for anything new that I enjoy, led me to an awful lot of leg pain the first couple of months.
I couldn't really help it - I was seeing such amazing weight loss results from the exercise and diet changes I had made. I just kept pushing myself harder and harder, and was running 30-40 miles a week after only a few months. I kept telling myself "no pain, no gain" as many others have before me. And like many others before me, I was wrong.
I quickly learned that changes would need to be made in my routine if I was to keep up this pace, as I also have a job where I am on my feet 10 hours a day - so sore legs were just not an acceptable outcome of running. I did not want to slow down on the running at all, but what I was doing just hurt too bad.
Being the geek that I am, I did extensive research on the subject - trying to decipher complex medical journals (which has become much easier as my schooling advances), reading running magazines and books and talking to other runners. In the article I will share with you what I learned both from the research and from several years of running experience.
What Are Shin Splints?
The term "shin splints" is not an actual medical term, but a layman's term that describes a general pain in the lower half of the legs. One of the most common problems that falls under the "shin splints" term is medial tibial stress syndrome (or MTSS for short). MTSS is a specific diagnosis that indicates a stress reaction within the tibia itself, however there are other occurrences such as strained muscles, inflammation of tissues and joints, or nerve problems. It is recommended to be examined by a physician if you experience recurring shin splints to get an more thorough diagnosis, as pain in the lower legs can also be caused by more serious problems such as bone tumors or lymphomas.
5 Easy Steps To Get Shin Splints
Too Much, Too Soon.
This is perhaps the most obvious of them all, since in most cases shin splints are an overuse injury - don't overuse! It is very common for new runners to gain overall stamina before the body is ready to handle it. After just a few months, I was doing 10 mile runs wearing a pair of cross training shoes (as opposed to the hiking boots I was wearing those first few months). And boy did my legs let me know how unhappy they were.
Between 60 to 90 percent of all athletes have experienced a sports-related injury that has forced them to make a change in their routine. And a majority of those injuries were caused by over training/overuse of muscles. It is worth spending a little time reading a book or magazine article that has some planned-out workout routines for beginners. These can save you a lot of pain and heartache down the road.
You should be aware that there are many other injuries that can occur if you take the "too much too soon" route. My wife had to all but stop running for several months after she injured her arches running too fast on the treadmill (wearing the wrong shoes). She then had to start over from scratch, running 5 minutes, walking 15. It took her around four months to fully recover from her injury. It's worth a trip to the family physician before you undertake any exercise routine!
The Wrong Shoes
Normally in my life I am what people refer to as "cheap" (I prefer "thrifty", but hey!). There are a few things I will splurge on, such as my running shoes. After the whole concept of not overexerting your muscles, this is probably the next best thing you can do to help prevent shin splints. When I made the switch from a pair of cross trainers to some top-of-the-line 0 running shoes most of my pain disappeared immediately. I was able to literally double my mileage and eliminate 95% of my leg pain.
It is really a good idea to head down to your local reputable running shop and get fitted by a trained professional. Many running stores have technology to analyze your stride and help you decide on the correct shoe. I wouldn't go blindly grabbing the first pair that looks pretty, as many of them are designed to correct specific problems, and If you wear a shoe that is supposed to correct your stride in a way that you don't need - you could actually be doing more harm than good.
They make a lot of shoes now for heavier runners with extra padding to help ease the stress on your legs and feet. If you are a big person like I was, I would strongly recommend investing in a good pair of shoes.
The Slippery Slope
Another common cause of shin splints amongst even the most seasoned athletes is running on an uneven surface. I personally like to do trail runs whenever I can to stay in the shade on a hot summer day, but It can be a real challenge trying to maintain your balance on crooked paths littered with tree roots and branches just waiting to take you down. All of these little twists and kinks in the body when running can really take their toll, not just on your legs - but also on your back and midsection as your torso works harder to maintain your posture.
I have personally found that dirt trails tend to be a little easier on the legs than concrete, as long as they are relatively level. Even the difference between cement and blacktop can be quite noticeable - remember your body is creating about three to four times your body weight's pressure on your legs and feet every step you take. On a long run, that can work out to thousands of steps, so every little bit helps.
Being Inflexible
There is no room for inflexibility in exercise - both in your routine, and your body. You have to be willing to make adjustments - back off a little if you start getting a cramp or leg pain. Take an extra day off if you need it.
Flexibility of the body will also help immensely, The muscle that becomes inflamed in MTSS is the muscle that flexes your foot upwards, which can often be affected by poor stride. There are some exercises you can do to help strengthen the muscles in this area as well as add flexibility. I will discuss these exercises in the next part of the article.
Not Dense Enough
A recent study done in June of 2008 has showed direct ties between bone density and the likelihood of getting shin splints. The study examined 88 subjects and found that those who remained uninjured during exercise were those with the highest bone density measurements in their tibia.
This is just stronger encouragement to make sure you are eating healthy and getting optimal levels of calcium in your diet. Remember, as an athlete you are putting your body through much greater stress than the average person, and you requirements for most nutrients are going to be higher.
Ouch! Already Got Them, What Do I Do Now?
So you ignored the advice, and got yourself a nice set of shin splints anyways! Well, there are a few things you can do to help get rid of them, although one of them is far more important than all of the others.
Get Some Rest!
If you have bad shin splints, that is your body's way of telling you, "I need a break"! So listen to your body, and take an extra day off running. This doesn't mean that you can't exercise, just that your legs don't need their daily pounding tomorrow. Perhaps a few laps in a pool, a few laps around the block on your bicycle?
Studies have consistently shown that rest alone is the one proven method to alleviate the pain, all of the others can be helpful to some, but are really only going to be effective in conjunction with proper rest.
R.I.C.E. R.I.C.E. Baby
Probably one of the most well known methods of alleviating shin splint pain is the (R)est (I)ce (C)ompress (E)levate principle.
First, you rest until the body has healed itself. You will know this has happened when you can return to the activity that caused it without pain.
Next you ice the swollen and painful parts of your body using a cold pack for approximately 20 minutes every hour. Be sure to not place ice directly on the skin, use a cold pack or ice wrapped in a towel. This can substantially reduce inflammation and swelling as well as pain.
You can compress the injury using an elastic bandage such as an Ace bandage to help reduce further swelling.
And finally, elevate the affected part of your body to reduce the pooling of blood and the swelling that occurs because of it.
You can apply some mild heat sporadically (for 15 minutes at a time) to help the pain, however overuse can increase blood flow to the area, promoting bruising and swelling as well as actually increasing pain.
Pop The Pain Killers?
Studies have shown that taking non-steroid anti inflammatory drugs can actually lengthen the recovery time from shin splints. If you do take them, take them after the run, not before. Taking them before can lead to dehydration as they can affect the kidney's ability to regulate water in the body, and they can also mask warning pains that are precursors to a more serious injury.
Exercises For Relief
First of all, you should consult your physician to help you plan an appropriate recovery strategy from MTSS. They will probably refer you to a sports rehab clinic where an exercise physiologist can give you an plan to get back into the swing of things gradually and safely.
There are numerous strengthening exercises one can do, many of which involve the gastrocnemius and soleus muscle complexes (some of the muscles in your calves), as well as exercises that involve flexing the foot upwards to strengthen the dorsiflexers (muscles on top of your foot). As I said, this is a category where you will need to seek the advice of a health care professional for best results, I don't want to throw out a few random exercises out and have someone hurt themselves more.
And finally, when you are exercising (especially running) - be sure to stretch properly before and after. There are entire books dedicated to stretching exercises so I won't go into detail here. And be sure to warm up properly. I start off every run by walking the first mile or so at a gradually faster pace so the transition from walking to running is quite smooth. It is generally a good idea to slow down the same way near the end, walk the last half mile or so to let your body wind down slowly and you will help avoid pain in both the legs and the occasional headache you get when you stop abruptly after a long run.
Sources Cited
Thacker SB, Gilchrist J, Stroup DF, Kimsey CD. "The prevention of shin splints in sports: a systematic review of literature". Med Sci Sports Exerc. 2002;34(1):32ý40.
Carr K, Sevetson E. "How can you help athletes prevent and treat shin splints?" J Fam Pract. 2008 Jun;57(6):406-408.
Story J, Cymet TC."Shin splints: painful to have and to treat." Compr Ther. 2006 Fall;32(3):192-5.
Braunstein, Joel B. "Avoiding A Trip To THE SIDELINES." Diabetes Forecast 52.9 (Sept 1999): 29. General OneFile. Gale. Eastern Michigan University. 29 July 2008 http://find.galegroup.com.ezproxy.emich.edu/ips/start.do?prodId=IPS
Gallagher, Sean P. "Medial Tibia (Shin) Release." Biomechanics 13.11 (Nov 1, 2006): 62. General OneFile. Gale. Eastern Michigan University. 29 July 2008
"Good news for shin splint sufferers." Morning Call (Allentown, PA) (August 1, 2006): NA. General OneFile. Gale. Eastern Michigan University. 29 July 2008
Logan, Catherine. "The scoop on running injuries: help runners to avoid common injuries--and to cope with them when they do occur." IDEA Fitness Journal 3.10 (Nov-Dec 2006): 39(3). General OneFile. Gale. Eastern Michigan University. 29 July 2008
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