• Pain in the shins

    28th April 2015 | donaldt
  • With the run-up to the marathon, it is always common to encounter athletes complaining of pain in the shins. This condition is generally referred to as shin splints, a most frustrating pain after all the hard training done to get fit for this annual event. The following will look into the most common factors which lead to the development of shin splints and how to tackle this condition. The shin is that bony surface on the inner side of the leg between the knee and ankle. As running longer distances increases with improved fitness levels, stress on the bones, muscles and ligaments also increases. The body needs to adapt to this higher stress. During this adaptation period some athletes start to feel increased discomfort in the shins commonly referred to as shin splints.

    Typically the muscles on the front of the legs are weaker than the power house and larger calf muscles found on the back of the legs.  Increased running and activity loads the weaker front muscles and coupled with characteristically short and tight calf muscles, a perfect environment is created for shin splints to develop.

    Pain arising from shin splints normally occurs in diffused areas on the front in the lower third of the leg.  The pain may start immediately on running or occur throughout the whole run especially on hills.  It may also be felt on walking or climbing stairs.  As with all injuries it is important to address these pains early to avoid injuries such as stress fractures from developing. Initial treatment usually consists of rest, and application of ice packs.  It is also always advisable to seek professional help as soon possible.

    Soft tissue massage around the area helps to decrease the pain and increase flexibility in the ankle area. Acupuncture is often used and provides successful outcome for pain relief.  Neoprene shin supports which keep the area warm also aid in the recovery of this condition.  Hydrotherapy is an excellent method of maintaining cardiovascular fitness without straining the lower limbs while suffering from shin splints.  Anti – inflammatory medication as prescribed by doctors help to decrease pain but they should never be taken in isolation without assessing the overall picture leading to shin splint development.  

    Shin splints may be avoided by adequate calf stretches, good frequently replaced footwear and through ensuring correct foot and lower limb biomechanics.  Over pronation describes the rolling inwards of one’s foot leading towards the typical flat foot a major factor contributing towards shin splints.  Corrective orthotics often help to support this over-pronation, support the foot better and relieve the increased impact passing through the lower limbs.  Running or training on hard surfaces should also be avoided to reduce the stress transferred to one’s legs.  Adequate screening before starting any form of physical exercises is always advisable. 

    Persistent shin splints indicate the possibility that stress fractures may have developed. These take longer to heal than shin splints.  Occasionally this could indicate the presence of some other condition with a different underlying cause.  In such situations the need to seek professional advice is a must.

    This article was published on the Sunday Times of Malta downloadable here.