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Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH

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Preventing the Nuisance of Shin Splints

Posted in
Fit Tips

Thursday, Jul 13, 2017

Shin splints is a generalized term for pain on the anterior (front), medial edge of the tibia (shin bone) and account for approximately 6 – 16% of all running injuries (Thacker et al., 2002). However, this condition is not exclusive to runners. Shin splints are also common in dancers, military recruits, activities requiring bursts of speed or sudden stops, individuals who have increased exercise duration/frequency/intensity, and those exercising on uneven surfaces. Other risk factors contributing to the development of shin splints include: poor flexibility in the calf muscles, weakness of the tibialis anterior (muscle located on the front of the tibia), overpronation, flat feet, and perhaps most importantly shoes that lack adequate cushioning. 

In general, shin splints occur due to inflammation of muscles (soleus and/or posterior tibialis), tendons, and/or connective tissue that connects the two bones in the lower leg. It may also be caused by a tiny stress fracture of the tibia. Typical signs and symptoms of shin splints include the following: sharp or dull pain, tenderness/and or swelling over the lower 2/3 of the inside of the shin bone. It is important to note that pain over the outside of the shin is not shin splints. Rather, it may be related to the inability of the connective tissue to expand when muscle blood flow is increased during exercise (otherwise known as compartment syndrome).

The best treatment for shin splints is prevention. The only recommendation based on peer reviewed research appears to be the use of well-cushioned shoes. Proper shoes are of extreme importance due to their shock absorption qualities and their ability to stabilize the ankle by preventing overpronation (Thacker et al., 2002). Unfortunately, more rigorous research is needed to identify the best preventative exercises for shin splints. Based on current literature, the exercises included in this fit tip seem appropriate. 

  1. Seated Calf Raise (soleus): It is unlikely that the calf muscles would require further strengthening due to the overworked nature of this muscle group. However, if calf weakness is present, this exercise might be adequate for prevention of shin splints.

Movement: Raise the heel higher than the ball of the foot and lower back to horizontal.

Tips: To amplify, progress the heel raises as above with inversion (posterior tibialis) where the sole of the foot is facing inward as the heel is raised. 

  1. Tibialis Anterior Heel Walk: The following exercise focuses on strengthening the typically weak tibialis anterior.

Movement: Walk forward on your heels for approximately 75 feet. Reverse direction and walk backwards.

Tips: This exercise can be progressed to walking with the sole of the foot turned inward for greater emphasis on the tibialis anterior.

  1. Tubing Ankle Dorsiflexion for the Tibialis Anterior: This exercise is an excellent progression of the Heel Walk. Tibialis anterior remains the focus, but with the addition of a resistance band.

Movement: Begin by assuming the neutral spine (upright) position. Raise the toes toward the shin and return to starting position with the foot parallel to the floor.

Tips: As adaptation occurs, increase the resistance of the tubing.

  1. Calf/Tibialis Combo: This exercise strengthens both, the tibialis anterior and the calf (specifically the gastrocnemius) muscles. The bent leg that anchors the mini band is performing an isometric (static) contraction while the extended leg is focusing on repeated contraction of the calf.

Movement: Flex one leg to approximately 90 degrees at the knee. Ensure that the foot of the bent leg is fully flexed toward the shin as this is the anchor for the mini band. The opposite leg is in full extension with the mini band located at the ball of the foot. Once in position, perform calf raises with the extended leg only. Once an adequate number or repetitions (12 – 15) have been completed, switch and perform the same movement on the other side.

Tips: Progress this exercise by increasing the resistance of the tubing.
 

Once the above strengthening exercises have been completed, try the following myofascial release and stretching techniques.

  1. Myofascial Release of the Calves: This technique involves the application of gentle, sustained pressure on the myofascial connective tissue for the purpose of eliminating pain and restoring motion.  

Movement: Begin by lifting the hips off the floor and rolling forward and backward until points of tension are found. Hold on the tender points until a 75% reduction in pain is achieved.

Tips: Do not roll over the ankle or knee joint.

  1. Seated Hamstring/Calf Stretch: It is recommended that the above shin splint prevention exercises are followed by static stretching, specifically of the calf muscles.

Movement: Keeping a neutral spine (straight back), lean forward slightly to the point of mild tension.

Tips: Inhale and exhale throughout the movement.

These exercises/stretches are just a few suggestions that may be beneficial in preventing shin splints. However, it is important to note that if you are currently experiencing pain on the anterior, medial part of the shin, seek medical advice and avoid strength training until cleared by a physician. With that being said, the exercises in this video are for preventative purposes only and should be utilized as such.

 

Thacker, S.B., Gilchrist, J., Stroup, D.F., Kimsey, C.D., (2002). The prevention of shin splints in sports: a systematic review of literature. Medicine and Science in Sports and Exercise, 34, 32 – 40.