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NEWS | June 14, 2011

Targeting shin splints

By Maj. Lee Warlick 628th Medical Group Physical Therapy flight commander

If you have ever felt pain along your shins after exercising or playing sports you may have experienced shin splints. This is an overuse injury caused by repetitive high impact activity that leads to inflammation of the lining of the shin bone (tibia) and possibly irritation of the muscles that are on either side of it. Shin pain is initially felt after exercise and over time, pain occurs at the beginning of exercise but lessens after warming up. The shins can be tender to touch. Shin splints are most common in runners after increasing their mileage, duration or speed too much, too soon. It can also occur from changing running surfaces or from prolonged running on hard surfaces.

Continuing to exercise at the same or higher level can lead to constant shin pain and further breakdown of the tissues causing the rate of breakdown to exceed the rate of healing. If treated properly, shin splints will normally resolve in six to eight weeks. However, chronic shin splints may take several months to heal.

Proper treatment is required to getting back in the action. Resting from the high impact activity will prevent further aggravation to the shins. Low or non-impact cardio exercises, such as biking and swimming, can help maintain endurance and cardiovascular training. To manage pain and inflammation, an ice pack can be applied for 20 minutes once or twice a day. For a faster icing method, freeze water in a paper cup. After tearing off of the rim of the cup, rub the ice over your shins for five to 10 minutes.

Lower leg exercises are essential for preventing and treating shin splints. Exercises should include stretching and strengthening the calf and shin muscles. Massaging the shins for a few minutes each day can also be helpful.

Walking and jogging on a soft surface two to three times a week allows for a gradual return to running without re-aggravating shin splints. Over time, the walking distance should gradually decrease as the jogging distance gradually increases. Once you are able to jog pain-free without stopping, you can gradually increase your speed. To prevent a recurrence in overuse injury, increase your running distance no more than 10 percent per week. Also, avoid landing on your heel or your toes when running. Contact the ground with the middle of your foot while you run. This helps reduce the impact through your legs and will keep your feet from rolling inward too much, thus lowering your risk of shin splints.

Wearing running shoes appropriate for your foot type is quite important in the prevention of shin splints. Generally, there are three types of arches: normal, flat and high. Feet with normal arches will contact the ground with the outside of the heel and the rest of the foot will roll inward or pronate as it contacts the ground. Flat feet tend to roll inward too much and high arches do not roll inward enough. The right type of running shoes can help correct these problems. Stability shoes provide good support for normal to slightly flat feet, while motion control shoes are needed for very flat feet. Cushioned shoes are necessary for high arches, while neutral shoes work well for those who have normal arches.

The best way to determine what type of running shoes you need is to have a gait analysis at the Health and Wellness Center. During this test, the HAWC staff will observe how your feet land while running on a treadmill. Based on the observation, they can educate you further on proper running shoes and technique. Call the HAWC at 963-4007 to make a gait analysis appointment. This service is available to all TRICARE beneficiaries.