Shin Splints

Posted in: Blog, Injuries by Ray on February 18, 2010

Now is the time of year when those of us training for marathons and half marathons start to put in some serious running miles every week. For some this increase will come at a price i.e. painful calves and shins commonly termed the dreaded “shin splints”. Already this month I have treated two runners with this, quite often, debilitating condition. So let’s have a look at what causes shin splints, how Sports Massage can help in the recovery process and how with a bit of luck and perseverance you can get back to full time training.

Sore to Touch

Shin Splints are often used as a catch-all term for a number of conditions that effect the lower legs. The more scientific name is Medial Tibial Stress Syndrome. All result in similar pain and extreme discomfort when running but are not necessarily shin splints!

Periostitis: The periosteum of the tibia or the outer layer of the bone at the front of your lower leg can become inflamed due to the muscle attachments continually pulling during movement. Usually you will feel pain somewhere along your shin at some point during a run and sometimes afterwards. This is a “shin splint.”

Compartment Syndrome: Muscles in the lower leg are “housed” in a number of tight fitting compartments. During long bouts of exercise, pressure in these compartments can increase and the compartment walls will provide very little “give” to relieve this pressure. Consequently, acute pain can occur which subsides during rest. This can get quite nasty and sometimes results in surgery.

Stress Fracture: Repeated overuse, changing form running on a soft surface to hard can result in a crack in the bone(s) of the lower leg and foot. Runners quite often suffer from a stress fracture of the tibia. Unlike the pain experienced with a shin splint you will find a very specific point of pain which may become excruciating if you tap it.

The first two conditions can be helped by regular deep tissue massage whilst the third (stress fracture) is largely resolved by allowing adequate rest and a very conservative approach to beginning training again.

Likely  Causes

The cause of most shin splint conditions is overuse or inappropriate training. Suddenly upping your mileage from 5 miles a week to 25 miles a week in an effort to claw back wasted training days due to being snow-bound could be one example. Sound familiar?! Running with shoes that are starting to wear or that do not provide adequate support for your running style could also be a contributor. Poor flexibility and lack of stretching can also exacerbate the problem.

The Road to Recovery

Shin splints or medial tibial stress syndrome (MTSS) can take up to 6 weeks to heal. The good news is that a regimen of deep tissue massage, appropriate stretching and strengthening and reducing training volume, intensity and duration can get you back out there in a lot less time.

Sports/Deep Tissue Massage will reduce calf tightness by lengthening the muscles, increasing flexibility and taking stress off the muscle attachments.

Stretching will maintain the good work done by the massage treatment. You need to stretch the back AND front of the calf. Stretch the big gastrocnemius muscle at the back with a straight knee and stretch the soleus muscle with a bent knee. To stretch the front muscle just kneel on a soft surface and try to lift your knee up a few inches. Feel a lovely stretch  from knee to ankle.

Strengthening is equally important if you don’t want the injury to reoccur. A really simple exercise you can do virtually anywhere is to tap your toes. Tap then to the left for 20, then to your right for 20 and then directly in front for 20 reps. You can do this at your desk, or waiting at traffic lights.

Reducing training volume is vital to allow recovery. Instead of running try swimming, or cycling or anything that can create an aerobic response but not put stress on the lower leg. Many clients have still been able to complete a marathon even though they have missed large chunks of running training. They have simply maintained their running fitness by choosing other forms of exercise for a while.

Ice! How can I forget ice! After every training session ice the affected area. This will rapidly reduce inflammation and pain. Never put ice directly on the skin. Use a bag of frozen peas or ice wrapped in a clean cloth. Once you are on the road to recovery try using ice then a hot compress. This will encourage circulation and promote healing. Wearing a tubi-grip bandage during the day isn’t a bad idea either as it will offer protection and warmth.

It may also be a good idea to visit a good running shop and get a video analysis on a treadmill. You may find that your feet roll in too much during running (overpronation). This can put a lot of strain on lower limb muscles and can be helped by correct shoe choice. Alternatively visit a good podiatrist who can assess your gait and advise if inserts (orthotics) may help your problem.

So if you think you are suffering from shin splints don’t despair! If in doubt give me a call or send me an e-mail and I’ll go into more detail regarding your specific problem. I’ll certainly do my best to get you back in your trainers ready for your big race!