If I were to do a study of running-related injuries, I’d bet money that the hottest topic would be shin splints.
Most runners at some point have a case of shin splints varying in degree from mild shin pain to a debilitating stress fracture of the tibia. Although common, it is both curable and preventable.
What are shin splints?
Shin splints are a catch-all phrase for a number of conditions that occur in the lower leg. Cases range from mild inflammation of the connective tissue that surrounds the muscles of the lower leg to the more extreme situation in which this tissue can actually separate from the tibia and be very painful.
Causes
Excessive impact to the lower legs is primarily created by heel striking. If you’re a heel striker, the repetitive shock of your heels hitting the ground will irritate the connective tissue in the muscles surrounding your shins resulting in pain.
Running in worn-out shoes, extended downhill running, running on an unstable surface or on a side-sloping street can all create excessive impact. To reduce the amount of shock to your legs, it is important to eliminate any heel strike while running.
Heel strike happens when you run with your trunk upright and reach forward with your legs as you stride. The best way to eliminate heel strike is to lean forward from your ankles as you run so your foot touches the ground underneath or even slightly behind your body. This allows you to land on your mid-foot and your legs swing to the rear as your feet hit the ground, eliminating any heel strike.
Overuse of the lower legs by pushing off with your toes to propel yourself forward can also cause shin splints. This causes the calf and shin muscles to support your body weight and push up against gravity requiring them to do more work than they were designed to do.
That’s a big job for a relatively small group of lower leg muscles to handle, and they will eventually complain in the form of soreness, inflammation and pain. Runners who start a training program will often run too far or too fast before their legs are ready to sustain the distance or the speed they’re running. Most beginning runners push off with their toes, which increases the stress to their unconditioned legs, especially the shins.
Starting a run too fast without allowing muscles to warm up before increasing speed can occur during interval track workouts or hill runs and can also increase the amount of push-off with the toes. Compared to your quadriceps and core muscles, the muscles in your shins are relatively small and can be easily over-worked.
Treatment
I recommend that you rest your legs in order to give your overworked shin muscles time to heal. Switch to swimming or some other form of exercise that doesn’t require impact on your lower legs.
Another solution is to ice the shins for 15 minutes three or four times a day to reduce inflammation with periodic elevation. These techniques can help heal shin splints but really only provide symptomatic relief as they don’t eliminate the problem, which is either overuse or impact to the lower legs.
Prevention
The pain of your shin splints might go away with rest but can return when you begin running again. If this is the case, you can gradually strengthen the muscles in your lower legs by running slowly, doing calf raises or walking on your heels.
Remember, it is not your shins that create shin splints. It’s the way you run. Lean forward as you run so that as your body falls forward, your foot strike lands slightly behind your center of gravity, eliminating heel strike and reducing impact to the legs. Without overworking your lower legs, you can put the threat of shin splints out of your mind forever.
Dr. Darryl Tannenbaum is a board-certified orthopedic surgeon with Columbus Regional Health’s Joint and Spine Center and Southern Indiana Orthopedics. He is a graduate of Harvard Medical School and completed his orthopedic surgery residency at University of Michigan. Tannenbaum has run in more than 20 races, completing marathons in places that include Boston, Berlin,
London, Antarctica and Tokyo.
