Too Much Too Soon
Pain along the front of your lower leg? You may have shin splints. Here’s what to do about them.
Medial tibial stress syndrome (MTSS), also known as shin splints, is a relatively common condition for runners, dancers, tennis players, and inexperienced athletes. Most often caused by pushing yourself too hard too soon, the pain of shin splints can get so bad you’re no longer able to run or perform, putting a quick end to your season. The key is prevention. If they do set in, it’s important to treat them promptly.
Here’s what you need to know about shin splints.
What Do They Feel Like?
Your shins are located along the front part of your legs below the knee. The pain, soreness, tenderness, and swelling of shin splints can occur either on the outer part of the front of your lower leg (anterior shin splints) or the inner part of the front of your lower leg (medial shin splints). The pain can affect one or both legs. In the early stages, you’ll just feel the soreness while exercising. But as shin splints worsen and go untreated, you may feel pain continually. Pain is usually more acute in the morning and when you try to flex your foot.
Don’t blame all lower leg pain on shin splints. Stress fractures—small cracks in the bone—cause sharp leg pain that’s usually in a localized area and feels better in the morning after rest. Compartment syndrome can also cause pain, nerve problems, and muscle weakness on the outer shins when the muscle swells and creates pressure.
What Causes Them?
It’s been years since you put on running shoes. One day you decide it’s time to get back in shape and go run a mile. Don’t be surprised if you develop shin splints. Athletes who do too much too soon or suddenly intensify their training routine put themselves at risk for shin splints. Other causes include overpronation (flat feet), forgetting to warm-up, wearing old or non-supportive shoes, or running on a slanted surface always in the same direction.
One or more of these factors combine to cause stress on the shinbone, muscle, and the connective tissues, leading to inflammation and pain.
What’s the Best Way to Treat Them?
Shin splints will not get better if you continue your high impact exercises. Running or dancing through the pain will only make it worse. While it may be hard to sit on the sidelines, it’s not hard to treat shin splints. The best thing to do is avoid the activities that cause pain, apply ice to the shins for 15–20 minutes several times a day for two to three days, and take an anti-inflammatory over-the-counter pain medication like ibuprofen to reduce pain and swelling. Medial shin splints will benefit from gently stretching your Achilles tendon and anterior shin splints will heal faster from gentle calf stretches. After a few days of rest, focus on low-impact activities (swimming or bicycling) to stay in shape until your shin splints heal (usually three to six months).
How Can They Be Prevented?
If you’ve had shin splints before, a physical therapist can help you determine if your shin splits are caused by your running form or the way your foot hits the ground. Tips to avoid shin splits in the first place include wearing supportive shoes designed to fit your foot type and using shoe inserts to help correct flat arches. You should also warm up before exercising, stretch afterwards, ease back into exercise after a long hiatus, and include strength training in your workout routine.
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Allan Alguire