Wednesday, November 5, 2014

Marathon runners to one mile a day runners are coming into the office in droves as the temp falls. Why? SHIN SPLINTS!!!!!

It is the time of year, that as the temperature falls the running injuries rise. One of the most common injuries that seems to be walking into the office lately is Shin Splints.  If you have ever had a shin splint you may be reaching down just to rub the front of your lower leg remembering the pain you used to have.  This is not a nice injury, especially if you are training for a marathon.

First of all, you might be asking yourself "Self, what is a shin splint?" I will explain.  A shin splint is inflammation on the front of the lower leg.  The culprit is usually from the repetitive micro-trauma that occurs when one is running on a consistent basis. The anterior tibialis muscle belly becomes strained and starts to pull on the tibia bone causing the most common anterior shin splint.  The inflammation occurs on the bone and on the attachment of the muscle to the bone.  The repeated stress, can over time lead to stress fracture of the tibia if ignored and not addressed.

How you get shin splints becomes an important question as well. If you want to treat anything you have to understand the root cause.  Some people get shin splints from a very simple culprit, shoe gear. Many times patients will explain that they run at least 5 miles a day and two big races over 10 miles a quarter.  Then they whip out their shoes that are missing all of the tread pattern on the bottom as well as holes in the toe box.  Bad shoes do not belong in the world of runners! Especially if you are running more than 3 days a week.  Big miles and bad shoes = all kinds of foot problems!  If you are a runner, you know shoes are your friends but they still will need to be changed out more than an average active person.  We tell the average person to change their shoe gear every 6 months.  I tell all of my runners that it is better to change your shoes every 300-400 miles and that buying two pairs of your favorite running shoes at the same time will at least increase the interval of time that you need to replace your shoes if you are rotating your shoes daily.  I created a little combo of some of my favorite running shoes that are great for support and stand up for long distances a little more than the average shoe for runners who are serious. These shoes are all available at FootSmart online.

Next, if your calf muscles are tight and you are not properly stretching you can get shin splints.  We are all born with more muscle in the back of our lower leg and less in the front.  The biggest problem with this is that these muscle groups are antagonist, they work against each other.  If your calf muscle is really tight you are going to hit the ground with the foot in a more plantar flexed orientation, meaning the foot is going to strike the ground with the foot more pointed down and pressure on the ball of the foot instead of a heel strike.  This breaks up your runners stride more awkwardly and causes you to have more strain on that front of the lower leg, especially when you push off on the next stride.  So stretching is key for runners to take the strain off of the front of the lower leg when they are prone to shin splints.  I have included my world famous stick figure drawings for stretching for your perusal.

There are other reasons that one may get shin splints but they are not as prevalent as the two main ones we go over above: bad shoe gear or warn out shoe gear and insufficient stretching are more often than not the main issues.  Look to these first before making any other big changes.

Treatment for shin splints is pretty straightforward, change shoes and stretch of course.  Also, your doctor may want to put you on a medicine by mouth to help with the inflammation associated with the shin splints.  I recommend icing and a period of rest in cases where there is a lot of pain associated with the shin splints.  Many of my runners are crazy and if you are a runner you may also fall under the crazy umbrella.  It is hard to get a runner to stop running, especially if they are a serious runner putting on serious miles.  I try to explain to all of my runners that if they give the injury rest and convalesce this correctly they will return to running with less of a chance of struggling for months and years on and off with shin splints.

I leave you last with the suggestion of using the compression type sleeves while running and putting on these big miles. Compression sleeves are not a treatment for shin splints or any other lower leg disorder but they have been proven in recent studies to increase blood flow to the most important areas while you are running.  Compression sleeves are a graduated compression from the ankle to up past the calf muscle itself. These types of sleeves help decrease the amount of swelling that may be occurring on long runs where gravity starts to help us keep more fluid in the ankles. These sleeves in a nutshell help the body with the venous return of our deoxygenated blood back to the heart.  The by product of this is also a decrease in muscle soreness and quicker recovery due to the lactic acid build up being more efficiently cycled through the body.  Even though the compression sleeve is not a treatment for shin splints, I do believe they can help stabilize that tibialis anterior muscle and may be able to decrease some of the shear force this muscle has with running on the anterior tibia bone.

So again, they keys to help you with your shin splints are:

1.  Good shoes: look at your shoes and changes them out if they are breaking down
2.  Stretching:  the calf muscle should be stretched several times a day
3.  Icing the injury will help with the local inflammation
4.  Compression sleeve may help improve and maybe prevent shin splints in the future
5.  See your doctor if your symptoms persist he or she may be able to put you on a medicine by mouth to help the swelling as well and they can take an x-ray to rule out a stress fracture.

Michele McGowan, DPM Owner and doctor of the Center for Ankle and Foot Care Clermont FL

If you are interested in learning more about other foot and ankle problems please feel free to visit our website at


1 comment:

  1. i think when you think to go about the marathon then you must choice the best shoe for shin splints.