Fitness Q&A by Richard Weil
Shin splints is a condition where there is pain along the shinbone (tibia) resulting from too much stress on the tibia and the connective tissues, particularly ligaments and tendons, that attach the muscles in the lower leg to the bone. They can be caused by sudden increases in mileage, walking or running uphill or downhill, walking or running faster than normal, jumping, running stairs, training for too long or too hard (overtraining syndrome), wearing poorly fitted or worn-out footwear, or starting with too much exercise after a period of inactivity. They can occur on the medial (inside) of the shin or on the lateral (outside) of your shin. Medial shin splints can be caused by excessive pronation or flat feet, pounding from running, or sports like tennis, volleyball, basketball, and other weight-bearing activities, particularly where you stop and start frequently. If you have medial shin splints and flat feet (excessive pronation), an orthotic device or over-the-counter arch support like Powerfeet or Spenco can sometimes be helpful for preventing shin splints. Make sure it's a full-length insert.
Lateral shin splints (sometimes called anterior shin splints) are usually due to overuse and inflammation of the anterior tibialis muscle and the muscle compartment in the front of the leg along the outside front of your shin. The anterior tibialis muscle flexes your foot upward, and individuals frequently get anterior shin splints from the repetition of flexing the muscle. For instance, walking fast and/or uphill on a treadmill, or increasing the speed or elevation substantially, can overwork the anterior tibialis muscle and cause it to cramp. This can lead to shin splints or just a simple case of muscle cramping.
It is difficult to stretch the anterior tibialis muscle to prevent shin splints. You can try to stretch the muscle by sitting and crossing your leg so your ankle is resting on the other knee and pulling on your foot (as if you are pointing your toe). This may or may not have an effect. Massage of the anterior muscle while in this position may also be helpful. Occasionally stretching the calves can help (the gastrocnemius muscle). To do that: (1) Stand facing a wall, (2) lean against the wall with both arms and elbows slightly bent, (3) bring one leg forward with the knee bent, (4) keep the other leg straight with the heel on the floor, and (5) lean the hips toward the wall while keeping your back straight. Another stretch that might be helpful is for the soleus muscle, which is low in the calf. To do that: (1) Do the standard calf stretch as described, (2) while in the stretched position bend the back knee slightly, and (3) you will feel this lower on the leg (just above your Achilles tendon). Hold all stretches until you feel looser.
To strengthen the anterior tibialis: (1) Sit on the floor, (2) tie an elastic exercise band around the leg of a table or chair and then wrap it over your toes, (3) pull on the band by flexing your foot, and (4) repeat 10 times for three sets. To strengthen the calves, do heel raises: (1) While standing rise up on your toes, (2) slowly lower to the floor, and (3) repeat 10 times for three sets. You can also do heel raises by standing on the edge of a step with your heels hanging off for greater range of motion (your heel drops lower than the step). Stop these exercises if you have pain.
The best prevention for shin splints is to find out what is causing it (for example, overuse, flat feet, etc.) and fix that problem. For example, if you are overtraining, then cut back; if you use the treadmill at the same speed and elevation all the time, then vary it; if you have flat feet, then an insert or prescription orthotic may be helpful; if you do impact sports, then take a break and cross-train with lower-impact activities like biking; if your shoes fit poorly or are worn out, then get new shoes. Shin splints can be persistent, and so if they continue, you ought to see your doctor for a proper referral to either an orthopedist or podiatrist. Your doctor will know what type of referral you need.
Take care, and thank you for your question.
Last Editorial Review: 11/6/2007
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