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How To Prevent and Treat Shin Splint Pain

Shin splints are an insidious injury that most often targets and frustrates many beginning runners. It’s a tough injury that can result in such soreness and even pain that many newbies—particularly young runners–are forced to abandon running.

That’s a shame because—given some basic understanding and knowledge—shin splints are usually preventable. And if you are unfortunate enough to come down with a case, the injury is also very treatable with some common-sense home remedies and therapy that can get you back on the road quickly.

First, a short definition. Shin splints is a catch-all term that refers to pain or soreness along the lower part of the inner side of the tibia (the shin bone in the front of the lower leg). Medically, it’s known as medial tibial stress syndrome.

Depending on the severity, the discomfort can be a mere soreness at touch to intense pain. It gets worse when you run or walk because the muscles of the shin area work to pull the foot up and those muscles get overused. When there’s shin splint pain, it often results in a limp.

Why exactly shin splints seems to target beginners is the tendency many novices have of running too many miles, too soon, on too hard a surface in poor shoes. The result of all this overuse can be inflammation of the muscles and tendons of the shin area.

Another reason beginners are at such risk is their legs are simply not accustomed to the stress and impact of running. Also, their legs may lack strength in the quadriceps (the big muscles on the front of the thigh), the hip flexors, calf muscles and hamstrings (the muscles in the back of the thigh). If these muscles aren’t strong enough, they don’t do a good enough job of stabilizing the lower leg well at foot strike. If that’s the case, this instability can create torque on the shin that results in shin splints.

Digging a little deeper, shin splints tend to be caused by too much stress on this sensitive area between the knee and ankle. The problem often boils down to overpronation which is when the arch collapses too much (inward) or at too great an angle upon foot strike which can be compounded by weak leg muscles. If you run too much on an overpronated foot (or “flat” foot) without some correction, the impact makes the arch of the foot collapse and shin splints are often the result. Running on an exceptionally hard surface such as concrete sidewalks or highly cambered roads can also make things much worse.

Women are especially prone to shin splints because they have wider hips than men which often means they pronate more which places great stress on the shin. Women also seem to have weaker lower leg muscles than men, possibly because of the dress shoes many wear that squeeze the feet and reduces the workload on their leg muscles.

How do you tell if you have shin splints? You will notice a gradual onset of soreness or a throbbing ache that can develop into pain to the shin area—usually the inner side of the shin. (It can also occur on the outer side of the shin bone.)

Symptoms may begin as a mere ache, but worsen whenever you start to run or walk. Running or walking downhill is especially painful. Usually, you can localize the pain or soreness to a particular spot and putting pressure on that spot makes the symptoms more pronounced.

Not fun. If this sounds like what you may have, you aren’t alone. Nearly everyone has had at least a mild case of shin splints at some point in their running.

The best advice is to take a complete break from running. Especially if there is pain. You should never attempt to run through shin pain. Don’t even consider it. If you do, a relatively mild case of shin splints could blossom into a much more severe injury, including a fracture of the tibia.

So take a break. Your body needs time to heal. As a cross-training alternative, swim or run in the deep end of a pool. Sometimes using an Elliptical Trainer is OK (if there isn’t any pain) or a stationary bike is often fine. But if there’s any pain or residual soreness from your cross-training activity, back off.

The next step is to treat the inflammation of the muscles and tendons of the lower leg that are creating the pain and soreness. Inflammation is heat which creates soreness and pain. The best remedy for heat is cold. If you can put the chill on those inflamed muscles, you can reduce the inflammation and eventually drive the soreness out.

Clearly, the most immediate home remedy is ice. Either get a bag of ice or a bag of frozen peas and plop it on the most tender area of your shin. Leave the ice on for 10-15 minutes. Repeat this two or three times a day.

An even better way to use ice is to freeze some water in a paper cup. Once it’s frozen, peel some of the paper away and massage the tender area of your shins for 10-15 minutes with the ice.

Ice is a valuable tool for soft-tissue injuries like shin splints. The ice will give you instant relief from the throbbing pain by reducing the blood flow to the injured area. This reduces the swelling and inflammation of the injured muscles. But the ice will also increase circulation in the injured area, bringing healing nutrients to the injured area. (Never ever use heat.)

Even numbing the area with the ice will help to break up the pain cycle you’ve been experiencing. You can also begin taking an over-the-counter, NSAID anti-inflammatory such as Aleve to help reduce the inflammation.

Another trick runners use is to crush up an anti-inflammatory and mix it with some aloe vera gel and then apply it to the sore area of the shin. Simply leave the mix on your sore area of your shin for several hours to get continual anti-inflammatory benefits.

After two weeks of rest and home treatment, the shin splint soreness should have dissipated. When you return to running, return very cautiously and slowly. Following any run, apply ice to the injured area to prevent the soreness from coming back.

When coming back from shin splints, start running again on a flat, soft surface such as the grass fields at Zilker Park or a nearby soccer field. Take it very slowly and back off at the first sign of trouble. (Again, ice after every run.)

If your injury has not responded well to home treatment and the pain and soreness lingers, consider making an appointment with a sports podiatrist who may take a more aggressive approach by possibly prescribing a more powerful anti-inflammatory medication and using muscle stimulation or ultrasound to reduce the inflammation.

The podiatrist will also perform a biomechanical exam to try and determine the root cause of the shin splints. If the podiatrist determines that overpronation is a primary cause, orthotics may be prescribed to place your feet in a more neutral position (rather, than pronated) in your shoes.

Fortunately, shin splints are relatively easy to prevent. Often the muscles in the front of your legs aren’t strong enough to stabilize the foot and it will roll too much when you strike the ground.

Once the inflammation has gone down, you should consider some leg-strengthening exercises. Go to a gym and do three sets of leg extensions, hamstring and calf curls, toe raises and exercises to strengthen the hip flexors. Do these three times a week.

Or, if you don’t have access to a gym, try this age-old classic: Fill a paint bucket with sand or water. Sit on the edge of a sturdy table and hook the handle around your foot. Lift the bucket to work the muscles in the front of your legs. Do three sets of 20.

Good flexibility is also key. Often, the hamstrings, Achilles, calf muscles, hip flexors and quadriceps are too tight, creating muscular imbalances. Learn to stretch the key muscle groups and do so after running.

The surface you run on is also something to consider. If you’re running at all on concrete sidewalks, stop. Absolutely do not run or walk on concrete as it will compound the pain and soreness of the shin splints because the surface is simply too hard.

Instead, run on a smooth dirt trail such as the Butler/Lady Bird Lake Trail. Even though it’s fairly firm, it’s still more forgiving than roads and will cause less stress on your shins. A treadmill is also fine. A track is not a great idea because the constant turning puts more torque on your lower legs than if you are running straight ahead.

If you run on roads, try to stay off the shoulder (or camber) as this will also place more stress on your lower leg. If you must run on the roads, try to stay as close as possible to the middle. Flat surface roads with wide bike lanes are your best bet.

Lastly, good shoes are important, but the right good shoes are critically important. If overpronation has been diagnosed as a problem, you should wear either stability or support running shoes. This type of shoes will reduce how much your feet overpronate—a leading cause, as we have seen, of shin splints.

Consult a shoe specialist at one of the top running stores in town—Luke’s Locker, Rogue Running, Ready to Run or Fleet Feet in Round Rock—for the exact type of shoe you need and try on a good selection of support shoes.