Wednesday, September 12, 2007

Anatomy of a Shin Splint

Yeah, yeah...shin splint...blah, blah. But what IS it exactly?

"Shin splint" is often an overused and generic term that simply means "lower leg pain near your shin". Also referred to as medial tibial stress syndrome, shin splints can certainly take all the fun out of running. Leg pain can be on the outside of the shin bone (imagine flexing your foot to isolate that muscle that is sometimes strained or overworked during hill workouts). This is referred to as anterolateral shin splints. What I have is posteromedial shin splints, related to the muscles in the back (posterior) and inner (medial) parts of the shin. These muscles are responsible for lifting the heel just before the toes push off.

This is the second year I have had this problem, and as I struggle to find some once-and-for-all-relief, I've found that there are many contributing factors. First, tight muscles. It's always important to warm up and stretch before and after taking off on a long run (or really any exercise). This often gets overlooked when we're in a hurry to get to our post-run happy hour. Or even, say, when we use a run to the School for the Deaf track as our warm up. I can think of many times when I don't stretch because I think I feel just fine.

The second thing going on with shin pain relates to the muscle tendons and the periostium, the sheath that surrounds the bone. Many people can have tight muscles and really not experience much pain. I can run longer distances on soft surfaces, stretch, get a good sports massage, and be fine. Add a few pavement pounding runs about town, however, and suddenly there is a significant difference. With the jarring that occurs with feet hitting concrete or crowned asphalt, the periostium can become inflamed and irritated, and may even generate heat. In fact, last year my shin splint got so bad that you could feel the heat on the skin's surface. Ouch!

Again if left untreated and running continues, tension on the inflamed tendon can actually pull it from its attachment to bone, causing internal bleeding (I have had some discoloration in the area), and possibly even a bone fracture. Now this is something I do NOT want to experience.

Every resource, doctor, RMT, PT, etc. will say this about shin pain:

  • Running is the #1 cause
  • If you want it to heal, you must stop running
  • Stretch and build strength in the affected muscles
  • Get frequent massage to stretch the deeper muscle tissues and work out any adhesions
  • Ice and elevate

Many people assume that running shoes contribute to the cause of shin splints, and it is true that running shoes should have enough support to asbsorb a lot of the shock that comes with running. However, changing shoes can only mask the larger cause of a shin splint (just like taking Ibuprofen, for example) and is not part of the treatment.

The good news in all of this is that swimming and cycling are recommended alternative activities to running during the healing process. And this makes me very happy.


mel said...


Thanks for the comment.

Let me know if you find anything that give you relief.

Anonymous said...

I experienced years of severe shin splints when I was very active in Soccer. A few things I found that worked...
Warm compress just before you work out helps to loosen up the muscles.
Put an ankle weight around your toes when you're watching TV and point and flex your foot, it helps to strengthen those shin muscles.
The BEST thing I have are some neoprene "sleeves" that my trainer gave me. They're basically sleeves that you wear over your shins when you're exercising. It holds the muscle close to the bone so that 1)the jarring is much less painful, and 2)the mainted contact of muscle to bone allows it to actually heal. I still have these years after my splints healed, but every now and then when I feel a flare up, I put them on for a couple work outs and have no problems!!
Good luck!

Anonymous said...

I've found that anytime I have postero-medial shin splints, it's from unaccustomed overuse of the long toe flexors. Self massage of the lower leg (inside, outside, back & front) is easily done and will not only reveal the tenderest areas, but will help immensely in addition to the rest, icing, stretching, strengthening and NSAIDs.