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With two feet of snow on the ground and “spring” sports starting this week, high school track athletes around the state will take to running the concrete halls of their schools.  Once it warms up, they will be joined by thousands of competitive and recreational runners as we all emerge from hibernation and head outside. Poor running surfaces, like concrete, and drastic increases in running volume can lead to a very common running injury:  shin splints.  By taking a few preventative measures, you can avoid being sidelined by shin splints.

What are shin splints?

Shin splints is defined as any pain along your tibia/shin bone.  Repetitive stress to this area, caused by running or jumping, can lead to irritation and inflammation of the bone itself, as well as the muscles of your lower leg that attach to the tibia.  If untreated, shin splints can progress to a stress fracture of the tibia.

What causes shin splints?

  • Tight calves and stiff ankle joints
  • Weakness in the hips, core, and muscles that support your lower leg and foot
  • Inefficient running form that relies on calves for forward propulsion
  • Repetitive trauma caused by running – typically following a drastic increase in training volume or intensity
  • Poor running surface – concrete, slanted surfaces like crowned roads
  • Inappropriate footwear – shoes that lack support or have too many miles on them

Prevention:

  1. Improve mobility:  stretch and foam roll calves daily
  2. Strengthen core, hips, and foot/ankle supporting musculature
  3. Consider what is under your feet: footwear and surface
  4. Slowly increase volume and intensity of training

Treatment:

In certain situations, shin splints can be difficult to avoid.  Initial treatments mirror prevention tactics and can be performed at home.  If home treatments fail to improve symptoms, consult a physical therapist for specialized treatment.

Reduce Load:  

Give your body  a chance to heal by taking 1-2 weeks off from high impact activity (jumping, running, etc.).  Maintain or improve cardiovascular endurance by biking, swimming, or aqua-jogging.  Ice massage and anti-inflammatory medications help to reduce pain and inflammation.

Mobility:  

As mentioned above, stiffness in the ankle joints and tightness of the calf muscles can contribute to shin splints.  Unfortunately, both ankle stiffness and calf tightness are very common in runners.  Runners should foam roll their calves for 5-10 minutes daily and stretch their calves 2-3x per day.  Hold each stretch for 30 seconds to a minute.  Check out our lower body mobility highlight on instagram for video tutorials.

Strength:

Many runners avoid the weight room, preferring to use their limited training time to put more miles behind them.  Improving the strength of your hips, core, and supportive muscles of your ankle and foot are key to improving running gait efficiency, which reduces injury risk and improves performance.  

Footwear:  

If your running shoes have 300-500+ miles on them, it’s time for a new pair.  Over time, the support through your arch and cushion through the heal of the shoe breaks down, which puts more demands on your body and alters your gait pattern.  A sports medicine physical therapist can assess your foot type and gait pattern to help you select the best shoe for you. 

Physical Therapy:

For an athlete suffering from shin splints, especially if they are recurring or chronic, physical therapy is a must.  A physical therapist can assess the soft tissue and joint mobility throughout your lower body, core/hip strength, running gait, training regimine, and footwear to determine what is causing your shin splints.  Together, you will develop a comprehensive plan to treat them.  Treatment typically includes soft tissue mobilization or dry needling to improve calf mobility, joint mobilization to reduce stiffness in the ankle joints, muscle activation to improve running gait efficiency, lower body strengthening to improve foot posturing and glute drive, and a graded return to running.  A physical therapist can also help you develop a long term plan to prevent your shin splints from returning.

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