What are shin splints and can I still run if I have them?

Shin Splints, or Tibial Stress Syndrome, is an injury caused by overuse or repetitive load at the shin area of the tibial bone in the lower leg. This overuse, or repetitive load, causes what is called traction periostitis, or inflammation of the outer layer of bone which attaches to muscle. Shin splints make up 10-15% of all running injuries and result in persistent dull leg pain.

So how did you get shin splints?

• Shin splints most commonly result from excessive running (over 20 miles/week)

• hill training early on in the season

• running on uneven terrain or cement

• running with improper shoe gear (lacking shock absorption)

• suddenly increasing your training intensity or duration

• having flat feet (over-pronating) or high arched feet

Shin splints usually cause tenderness along the front of the lower leg and feel worse when you plantarflex, or put your foot in the position you would when stepping on the gas pedal in your car. Shin splints can be differentiated from exertional compartment syndrome (ECS) by noting whether your pain decreases when you start running vs increasing which is seen with ECS. Flat feet, tight Achilles tendon, and weak core muscles are other factors noted on physical exam. Imaging is not usually needed unless there is suspicion of a stress fracture in the area.

What does Treatment for Shin Splints entail?

The number one treatment is to start by reducing activity levels which can include:

• decreasing running frequency, intensity and distance by half

• running on synthetic track, being careful to avoid uneven or hard surfaces

• low-impact and cross-training exercises

After running, cooling immediately and the use of NSAIDS will reduce inflammation.

What about your shoes?

• Change shoes every 250-500 miles (shoes lose shock absorbance over time)

• use orthotics in your shoes, which can be supplied by your Foot Doctor

• shoe modifications can reduce pain significantly and provide the supportive and functional boost your feet need

To prevent shin splints be sure to stretch before activity and strengthen the invertors and evertors of the calf. When you start a new exercise program, start slowly and increase the intensity by 10% weekly.

The bottom line is, shin splints are painful and can feel debilitating when experienced but they should not prevent you from ultimately getting back into running and enjoying your usual activities!