One of the most-common injuries seen in young runners is shin splints. Shin splints is a term used to describe the pain resulting from inflammation of the tissues and muscles that attach to the tibia or shinbone. Shin splints are usually described as pain that occurs during exercise along the lower leg. The pain ranges from moderate to severe and usually dissipates after exercise stops.
There are several risk factors that may contribute to shin splints in young athletes. The most common is overtraining and overuse. Once shin splints develop, training schedules should be evaluated and weight-bearing exercises should be stopped until symptoms subside. The second risk factor is overpronation of the foot. Pronation is defined as the inward rolling of the foot causing a flattening of the arch. Athletes who overpronate cause the muscles of the foot and lower leg to overwork in an attempt to stabilize the foot. This causes muscles to strain or pull where they attach to the tibia. Another common cause is improper or worn-out shoes. Shoes should be checked for good arch supports, stability and cushioning. Finally, shin splints can result from a muscle imbalance between the anterior (front) and posterior (back) leg muscles. Usually, the posterior muscles are too tight or too strong, causing the anterior muscles to work harder and longer.
Various treatments can be helpful in relieving the pain of shin splints. The most important and effective of these is the application of ice. Ice should be used after activity for no more than 20 minutes at a time, and should be re-applied periodically throughout the day. Specifically, ice massage works best. Secondly, running and other activities that cause an increase in pain should be curtailed immediately. During this time, non-weight-bearing exercises such as biking and swimming should be used to maintain fitness. Gentle stretching of the posterior leg muscles in combination with anti-inflammatory drugs also will help decrease the pain.
After the symptoms have subsided, athletes can gradually return to their training routine. Running should begin on a soft surface such as a treadmill or grass, slowly returning to dirt and then to asphalt before concrete. Arch supports and orthotics will help keep an overpronated foot supported and in the correct biomechanical position during activity, taking the stress off the injured structures. Stretching and strengthening of the lower leg should be done twice a day if possible. Stretching of the anterior and posterior leg must be done a minimum of three times each with a 20 to 30-second hold. Heel walking and resistive ankle exercises also may be helpful.
Through preventive techniques and proper rehabilitation, shin splints do not have to be a problem. Start treatment at the first sign of pain, and hopefully, the shin pain will not progress to hinder any further activity. Contact a physician or a Total Rehabilitation professional if you have questions.
Beth Emeterio is a certified athletic trainer with Blount Memorial Total Rehabilitation. Total Rehabilitation offers certified athletic trainers assigned to area middle and high schools, free injury assessments for student athletes, goal-oriented rehabilitation programs, home and away athletic event coverage, injury-prevention conditioning programs, and personalized rehabilitation plans including physical and aquatic therapies.