Primer on shin splints

[footdoc]

Over the past few months I have learned a ton from the people on this site. I figure that it's my turn to contribute in my area of expertise. I have answered several posts recently about shin splints and I know how common it is. Unfortunately its misunderstood by many people including many doctors.

Ok shin splits are basically a combination of myositis(muscle inflammation) and tendonitis. There are two types of shin splints...anterior and posterior. The leg is subdivided into compartments. There is an anterior, posterior, and lateral compartment to the lower leg. The fascial compartments prevent the spread of infection from one compartment to the other.

Ok now a little about pronation. Pronation is a normal motion consisting of three movements....adduction, plantarflexion and eversion. Excessive pronation in the subtalor joint (joint between the heel and the talus) causes stretching and slight tearing of muscles and tendons. This is the etiology of shin splints. It matters not if your arch is high or low. Uncompensated pronation in a high arch foot is a bitch to deal with. Sometimes a super low arch is easier to deal with. I have actually treated NFL players with super flat feet who were wide receivers.

The anterior shin splints involves mostly the tibialis anterior muscle which in important for the breaking action of your foot as it hits the ground. Symptoms would be pain on the antero-lateral side of your leg and extending down towards your foot.
Posterior shin splints mostly involve the tibialis posterior muscle which helps to support your medial arch.

Treatment is the same for both
1. Rest is important
2. Custom orthotics will help stop the excessive pronation and solve the problem
3. NSAIDS like motrin will give temporary relief
4. In some cases physical therapy involving ultrasound and ionophoresis can be helpful
5. Motion control shoes are very helpful
6. Running inside on a treadmill can help some

Hopefully this clears up most of the confusion and helps everyone. Thanks again for the help everyone has offered to me.

 

[ncgymnut]

Thanks Footdoc for the info. It was very informative. I have them all the time and recently got some motion controlled shoes and they have cut down the pain but I still get a little pain. Would adding custom orthotics help also? Thanks

 

[footdoc]

Thanks Footdoc for the info. It was very informative. I have them all the time and recently got some motion controlled shoes and they have cut down the pain but I still get a little pain. Would adding custom orthotics help also? Thanks

Yeah thats the best treatment. However, make sure you go to a board certified podiatrist for this. Most ortho docs are not good for this

 

[bran987]

What are the best running shoes?

 

[footdoc]

What are the best running shoes?

depends on your foot type. Go to the nike store website. they have shoes for all types of feet. I wear the nike air triaxx. its great for someone who has an unstable foot

 

[stevesmi]

I've suffered from shin splints for 2 years. and also suffered while in high school. I feel that there is nothing that can be done once u get them chronically except to stop running and rest and they will eventually go away.

i think your OP is a great way to avoid them except the running on the treadmill part. i think running on grass most of the time is the way to go. the treadmill is a poor surface and can hurt your technique which can lead to them as well.

i would suggest anyone who starts getting them to STOP immediately and re-evaluate what you are doing that is making your situation worse. if you keep pounding away you will end up like me and unable to run.

the main mistakes I've made when i've gotten them I have narrowed down

1. poor shoes.. go and get fitted properly and pay up for decent shoes, dont buy cheap walmart shoes (the money you save is not worth it, cuz they dont last anyway)
2. poor surface.. running DOWNhill, running on uneven surface, running on HARD surface (sidewalks are the worst), treadmill running
3. over training.. you dont need to run everyday to become a better runner. 3-4X a week is all you need. one of those runs should be hard, the rest easier.
4. weak shins vs. strong calves.. make sure you keep your muscles loose and equally strong. warm up beforehand

 

[DIG_]

This is a lot of help!

 

[Therapy]

I competed in Cross Country (3K, 5K, and 8K) and long distance running from jr high till I graduated high school. I also competed in other endurance sports til I was in my mid 20's. In that time So that's about ten years all together. Proper running technique is extremely important. It does not matter if you are going up hill, down hill, jumping over obstacles, hard or soft surfaces etc. What matters the most is the mechanics of how you are running. A good running coach can instruct you in maximizing how you run so you use less energy and don't get hurt as much. Also if you can I would see a good sports medicine doctor about the injuries and get his/her advice.

The way I always looked at it was that if the heel of my foot was extended past my knee then I was going into shin splints territory. There is a balance between the front and rear muscles of the lower leg. Or thats the way I remember it being told to me by our doc.

Proper warmup (a slow stress free jog) and proper stretching techniques as part of the warm up. It's not a race, no need to show boat, just take it easy and bring your heart rate up until you start to break a sweat. Dont over stretch nor bounce during warm ups. Doing so can lead to an injury.

Well thats me two cents .... hope footdoc approves ?

 

[fuegoslow]

Proper running technique is extremely important. It does not matter if you are going up hill, down hill, jumping over obstacles, hard or soft surfaces etc. What matters the most is the mechanics of how you are running.

This ^^^ Well said.

One of the most ignorant comments I've ever heard came from an obese mother of an ex-girlfriend I had in High School. She said, "Running is so bad for you". I just about laughed my ass off! Or, wait... LMAO!

 

[stevesmi]

I will add to what I said above.. the last few posts are great ways to AVOID shin splints.. but once you get them unfortunately changing shoes may help but once it becomes chronic you are history.