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February 9, 2012

Shin Splints (cont.)

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What is the treatment for shin splints?

Previously, two different treatment management strategies were used: total rest or a "run through it" approach. The total rest was often an unacceptable option to the athlete. The run through it approach was even worse. It often led to worsening of the injury and of the symptoms.

Currently, a multifaceted approach of "relative rest" is successfully utilized to restore the athlete to a pain-free level of competition.

What is the multifaceted "relative rest" approach?

The following steps are part of the multifaceted approach:

  • Workouts such as stationary bicycling or pool running: These will allow maintenance of cardiovascular fitness.


  • Application of ice packs reduces inflammation.


  • Anti-inflammatory medications, such as ibuprofen (Advil/Motrin); naproxen (Aleve/Naprosyn), are also a central part of rehabilitation.


  • A 4-inch wide Ace bandage wrapped around the region also helps reduce discomfort.


  • Calf and anterior (front of) leg stretching and strengthening address the biomechanical problems discussed above and reduce pain.


  • Pay careful attention to selecting the correct running shoe based upon the foot type (flexible pronator vs. rigid supinator). This is extremely important. In selected cases, shoe inserts (orthotics) may be necessary.


  • Stretching and strengthening exercises are done twice a day.


  • Run only when symptoms have generally resolved (often about two weeks) and with several restrictions:


    1. A level and soft terrain is best.


    2. Distance is limited to 50% of that tolerated preinjury.


    3. Intensity (pace) is similarly cut by one half.


    4. Over a three- to six-week period, a gradual increase in distance is allowed.


    5. Only then can a gradual increase in pace be attempted.

Caveat!

The extent of injury that occurs prior to any rehabilitation program plays a significant role in determining the time frame necessary for complete recovery.

Shin Splints At A Glance
  • Shin splints are a type of "overuse injury" to the legs.
  • The pain is characteristic and located on the outer edge of the mid region of the leg next to the shinbone (tibia). It can be extreme and halt workouts.
  • The diagnosis requires a careful focused examination.
  • A multifaceted approach of "relative rest" can restore a pain-free level of activity and a return to competition.
  • The "relative rest" approach includes a change in the workout, ice, rest, anti-inflammation medications, stretching exercises, possible change in footwear, and gradual increase in running activities.

Additional resources from WebMD Boots UK on Shin Splints

REFERENCES:

Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.

Ruddy, Shaun, et al., eds. Kelley's Textbook of Rheumatology, 6th ed. Philadelphia: Saunders, 2001.


Last Editorial Review: 7/1/2010


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