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Shin splints explained
PETE GLADDEN
Pete’s World
Published: August 3, 2020
If there’s one malady that most athletes have all shared at one time or another, it’s got to be shin splints. Heck, I had them as a high school pole vaulter. I had them as a 5K and 10K runner. I had them in as a marathon runner. And I had them as a long distance hiker/backpacker.
Yup, shin splints seem to be one of the most prevalent overuse injuries out there, and it can crop up on any person who uses the legs for sport and recreation.
The term shin splints is used to describe pain in the lower front of the leg, right along the top of the tibia. And actually there are several conditions that can cause pain in that particular area, but by far the most common shin pain is the result of a malady called medial tibial stress syndrome (MTSS) - the subject of today’s column.
In its publication, Health & Fitness Journal: November-December 2009 - Volume 13- Issue 6 - p 5, the ACSM (American College of Sports Medicine) describes MTSS as “pain in the lower portion of the shin along the inside edge of the bone during running or other high-impact activities. This pain is linked with an irritation/inflammation of the membrane (periosteum) surrounding the tibia. Tendons attaching to the tibia also may be irritated.”
The prevailing symptom of MTSS is pain along the border of the tibia, which is sometimes accompanied by mild swelling. The pain can be sharp and razor-like or dull and throbbing, and it can occur both during and after exercise.
MTSS primarily results from overuse, especially in individuals who participate in repetitious activities like walking, running, sprinting and jumping. And the condition is more likely to occur when: one undertakes a sudden increase in volume/frequency/intensity of training; one undertakes a new sport too aggressively; one engages in high-intensity sports like sprinting, basketball etc.
Other factors that can contribute to MTSS include having flat feet, abnormally rigid arches, and exercising with improper/ worn-out shoes.
So let’s take a look at these causes more closely. The first two - sudden increases in the volume/frequency/intensity, and undertaking a new sport too aggressively - can typically be avoided by adhering to the classic 10% rule, a rule which states that workout volume/intensity should not increase by more than 10% per week.
And three of the most prevalent situations that contribute to breaking this 10% rule are: when preseason athletes overload on volume/frequency/intensity because their fitness wasn’t maintained during the offseason; when individuals begin a new sport or physical activity far too aggressively; and when seasoned athletes become overzealous with their training…this one I plead double guilty to.
These scenarios strain bones and connective tissue beyond what they’re able to handle, laying the foundation for an overuse injury like MTSS.
That third cause, participation in high-intensity sports, involves repeated high-impacts that put a strain on the bone and connective tissues. And although the bone attempts to adapt to those repeated stresses, its ability to adapt can still be overwhelmed without proper rest…and then its response is inflammation.
There’s also a risk for MTSS by running too much on hard surfaces and/or by wearing running shoes without adequate support and cushioning.
MTSS can typically be dealt with by implementing a protocol that goes by the RICE acronym: Rest - You’ll need to stay away from high-impact activities for 7 to 10 days, then gradually return to your sport of choice; Ice - Ice massage the inflamed area several times a day for approximately 15 minutes, especially after the activity; Compression - Apply light pressure to the inflamed area with an elastic wrap; Elevation - Elevating can sometimes help to alleviate the swelling.
Anti-inflammatory meds can also help to reduce the pain and swelling.
So when should you consult a doc? A doc is definitely the way to go when your shin pain is intense and does not dissipate with the RICE protocol. At that point only a qualified medical professional can determine the precise cause of your pain and prescribe the appropriate treatment.
When you boil it all down though, the best prevention for MTSS is using common sense while training and listening to your body…which isn’t necessarily an easy feat.