Shin Splints
Shin splints, or as it’s described by the medical community, Medial Tibial Stress Syndrome (MTSS), is one of the most prevalent injuries amongst runners and causes pain along the tibia (shin bone) (1,2,5). Despite the tibia being a very strong bone, it is susceptible to injury in deconditioned runners. When running, the shin bone can experience forces several times your bodyweight!
Symptoms of Shin Splints
The classic symptom of shin splints is pain along the front of the shin bone. Runners affected by shin splints often point to the exact spot of their discomfort. Usually, there is an associated history of “ramping up” their miles in anticipation for a race or before a new training program. The pain predictably comes on about 5-10 minutes into the run and is relieved with rest. In severe cases, the pain may be present at rest or when walking. The pain can be so severe that running is impossible. If the tissues around the injured bone are swollen, there may be a palpable lump at the spot of maximal discomfort along the shin bone.
Common Causes of Shin Splints
The anatomical source of the pain is often debated and theorized to be due to inflammation of the muscles, tendons, and other tissues surrounding the shin bone. The periosteum, which is a tissue envelope that provides the shin bone with nutrients to heal, can become irritated in shin splints. Newman et al. reported that it’s the bone itself that becomes inflamed. Recent evidence suggests it is in fact the bone that is the source of the pain, due to a phenomenon called “bone stress reaction” (4).
Certain factors have been established that place runners at higher risk of developing shin splints, including being female, having a previous history of shin splints, limited running experience, use of foot orthotics, being overweight, increased foot flexibility (specifically navicular drop), and male runners with increased hip external rotation (4).
Treatment & Prevention of Shin Splints
The current standard of care for shin splints is the traditional anti-inflammatory methods of rest, ice, and over the counter medication. Alternative interventions have been investigated but none have conclusively been shown to be more effective, which is unfortunate because recovery times can be long (4). One study reported that is took an average of 102-118 days, and as long 300 days for runners to recover to the point where they could run for 18 minutes (3). Anecdotally, one modality that is effective is circumferential compressive athletic tape around the area of discomfort to help support the soft tissues and periosteum. In severe cases where the “bone stress reaction” associated with shin splits progresses to a “stress fracture”, surgery may be indicated to prevent a complete fracture or break in the bone. A word of advice, don’t try to be a local athletic hero. If you’re having debilitating pain, go to your local orthopedist and get an x-ray to make sure you don’t have a stress fracture!
Now get out there and live a Strong Healthy and Happy life!
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references
- DIAS LOPES, A., HESPANHOL JUNIOR, L.C., YEUNG, S.S. and PENA COSTA, L.O., 2012. What are the Main Running-Related Musculoskeletal Injuries?: A Systematic Review. Sports medicine, 42(10), pp.891-905.
- Fredericson, M. and Misra, A.K., 2007. Epidemiology and aetiology of marathon running injuries. Sports Medicine, 37(4-5), pp.437-439.
- Moen, M.H., Holtslag, L., Bakker, E., Barten, C., Weir, A., Tol, J.L. and Backx, F., 2012. The treatment of medial tibial stress syndrome in athletes; a randomized clinical trial. BMC Sports Science, Medicine and Rehabilitation,4(1), p.1.
- Newman, P., Witchalls, J., Waddington, G. and Adams, R., 2013. Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Open Access J Sports Med, 4, pp.229-41.
- Taunton, J.E., Ryan, M.B., Clement, D.B., McKenzie, D.C., Lloyd-Smith, D.R. and Zumbo, B.D., 2002. A retrospective case-control analysis of 2002 running injuries. British journal of sports medicine, 36(2), pp.95-101.
In Part 6 of this series of articles, Cathy describes her daily core strength and flexibility routine to stay strong and mobile.