Preventing Early Season Injuries; Shin Splints

So as the days get longer and warmer as spring approaches I wanted to remind everyone to take it easy as you switch to running outside.  The following are the most frequent causes of shin splints, and other types of lower extremity sprain, and strains:

  1. Running Downhill
  2. Running on a canted (slanted) surface
  3. Running in worn out footwear
  4. Running without the proper support if you’re a pronator or supinator
  5. Training too hard, too fast, too long… and too soon in the season

The signs of shin splints are tenderness; soreness, pain, and possibly swelling at the inside lower Tibia (Shin Bone).  It happens when the Tibialis Posterior muscle, and the surrounding muscles, fascia, and periosteum (covers the bone) are overloaded and then injured.

The treatment for shin splints is rather straight forward, and the following are things you can do at home:

  1. Rest- until you are healed you must avoid running temporarily.  Replace with bike, swim, or aqua jogging.
  2. Advil, Advil, and Advil- It works, this is coming from a chiropractor, and I use it also.  400-600mg every 4-6 hours for the first 1-4 days .  If swelling lasts longer than 7 days consult a doctor.
  3. ICE, ICE, and ICE- it also works to take down swelling, and tighten connective tissue after injury.  10-15 minutes of ice wrapped in a thin towel every hour when you can.   Elevate the leg above the heart when you ice to help lymph drainage.  Wear an ace bandage for compression.
  4. Check your shoes and your feet.  If your shoes are too old and worn out… throw them out!  If you know you are a pronator and are not in the proper running shoe with the right support or orthotics inside, get them.  Store bought or custom made will work, and something is better than nothing.  It applies if you are high arched or supinated. You need the right shoe, and the right support inside.

You can return to running when you have full range of motion of the ankle and foot without pain in the tibia, and full strength in plantar flexion, and dorsi flexion of the ankle.

There are cases where simple home – based care is not enough and medical advice should be sought.  If the swelling gets hot, or seems to be getting worse, and pain persists during rest consult a sports medicine professional.   Occasionally, a stress fracture must be ruled out with an x-ray.

If pain returns with running even after a home care program and rest have been attempted, a consult with a sports medicine professional should be made.  This would be to get an accurate diagnosis, and for referral to the proper specialty for treatment.  This would include physical therapy, sports massage, or active release techniques.  Goals of professional care would be to relieve pain, to reduce inflammation, strengthen the weakened muscles, and to educate how to safely stretch the affected muscles.  When the muscles and surrounding connective tissue have been injured scar tissue and adhesions form in the muscle, fascia, and tendons.  This must be broken up to restore normal muscle fiber direction and length, to improve circulation within the muscle, and to decrease the friction and tension in between the surrounding tissues. All of these techniques may be necessary for a complete recovery and return to running and or triathlon training.

When starting back to running after home based or professional treatment use the following as a guide to getting back to running safely:

When you return to running remember to start back slowly at first, and be sure that you run on the FLATS!!!!.  Spin or walk for 5 minutes, then stretch your legs, thighs, hips, and back for 5 minutes.  Then you can run or jog for 15 to 20 minutes, and do a light post run stretch.  Maintain this every other day for 2 weeks if you have no pain during running, and minimal to no post run pain the day after.  After 2 weeks if you still have no pain while running and post run you can increase your time by 10% per week therafter.  Do this again for 2-4 weeks, every other day.  If there is no pain in your shins or calves at this point you could continue to increase the duration of your workouts, and start other more intense training or drills GRADUALLY!!!  Be mindful of hills, hill repeats, speed work, and other intense workouts when you are starting back.

It’s a long season ahead, and there is plenty of time for intensity when you are sure your leg is 100%.  If you have a question about a sports injury, or have an injury that has not responded to treatment Dr. Ness can be reached at (845) 255-1200, or by filling out our contact form.

Dr. David Ness is a certified sports chiropractor practicing in New Paltz, N.Y.  Dr. Ness is the official chiropractor and Active Release Techniques provider for the Vassar College Athletic Dept.  Dr. Ness  has worked at the Lake Placid Ironman event as part of the ART treatment team since 2004.  Dr. Ness has been the ART provider for the Hudson Valley Tri Club since 2005 years providing free ART care after club races.  Dr. Ness also provides treatment at NYTC races around the NY metro area, and continues to work as part of the SOS Triathlon post-race care team, and at American Zofingen Ultra Duathlon.