Ask The Therapist?
By Carol Pietromonaco PTMBA, N.E. Physical Therapy Plus, Inc. www.iphysioptpodcast.com
Q. I recently started running last month and I started getting achy pain in my shins. It has been getting worse every time I run. What should I do? Signed, new runner.
A. Dear New runner,
You may be suffering from “shin splints”. It is not uncommon for runners to experience pain in their calf or shin. The term “shin splint” is not specific to any one problem but is usually do to a collection of signs and symptoms in the soft tissues of the lower leg. It is possible for untreated shin splints to progress to a stress fracture of the bone in the lower leg. If you suffer from shin pain that is not responding to rest, it is important to have it evaluated by a physician to rule out the possibility of stress fractures. Understanding the circumstances that lead to shin splints can be the key to treating and preventing them.
Signs and symptoms of “shin splints”
Pain is usually located on the inside of the lower leg |
Pain is often worse with running or other weight bearing exercise |
Pain may linger even after exercise |
Pain may be associated with tight calf muscles |
Causes of shin splints
Loss of flexibility: Muscles in the back of the calf known as the gastroc-soleus muscle group can affect how our foot hits the ground. A tight calf muscle is not able to absorb as much force as a pliable muscle. These muscles also attach on the calcaneus or “heel bone” through a large tendon called the “Achilles tendon”. A tight calf muscle and corresponding Achilles tendon can alter the mechanics of the heel bone and forefoot causing abnormally high forces in the lower leg. |
Poor running surface: We can reduce the pounding forces through the lower leg by reducing the forces of the running surface. You should avoid prolonged running on hard surfaces. Try to run on softer surfaces such as the shoulder of a road or a running track that has a cushioned surface. If you always run on tracks be sure to change direction to alter the repetitive ground forces associated with the turns of the track. |
Improper footwear: Running in worn out shoes is often the triggering incident of shin splints in runners. Check your shoe mileage - you may be overdue for new shoes. They may have lost their shock absorbing ability. Remember that most running shoes are in their prime functionality between 100-300 miles so try to track your mileage. |
Improper foot mechanics: The sole of the shoe does not have to be totally worn down to injure you. The sole of the shoe as a whole might look fine but inspect the sole for one particular spot wearing down. This indicates that your foot is not hitting the ground evenly and can cause abnormal forces in into the lower leg. The type of running shoe you wear is very important. You may have collapsed arches or flat feet and this can put you at higher risk for overuse conditions such as shin splints and you need to be careful to choose running shoes that accommodate you particular anatomy. Sometimes a customized insole for your running shoe called an orthotic needs to be constructed to assist your foot in meeting the ground properly. |
Improper training: Keep a training log and check it on a regular basis. Make sure that you have not had a sudden large increase in your mileage, your running pace or the type of terrain you are running e.g. a recent addition of hills into your running route. |
I am in pain now what do I do?: Here are a few suggestions to help you to return to activity:
Rest: You must give the injured tissue time to heal and remodel |
Ice, This is by far the best home treatment for reducing the inflammation associated with shin splints. The best form of ice is to massage your leg with a large ice cube or a frozen |
Stretch: A proper pre and post running stretch program can reduce your incident of shin splints particularly if there are tight muscles present. It would be helpful to consult a physical therapist or other sports trained professional to set up the ideal stretching program for you. |
Gradual Return to activity:. A frequent mistake is to return to your previous running profile the minute you no pain in your leg(s). Build your running up slowly to your pre-injury training level. You might want to consider conditioning with low impact activities such as water running and cycling first before you hit the hard pavement of the roads again. Think about changing your running surface and inspect those shoes. |
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