Shin Splints (cont.)
How were shin splints treated?
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?
This multifaceted approach includes:
- Workouts such as stationary bicycling or pool running:
These will allow maintenance of cardiovascular fitness.
- Icing 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 addresses 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:
- A level and soft terrain is best.
- Distance is limited to 50% of that tolerated
preinjury.
- Intensity (pace) is similarly cut by one half.
- Over a three-six week period, a gradual increase in
distance is allowed.
- Only then can a gradual increase in pace be
attempted.
Caveat!
The amount of injury that occurs prior to any
rehabilitation program plays a significant role in determining the
time frame necessary for complete recovery.
- 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 shin bone (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, antiinflammation medications, stretching exercises, possible change in footwear, and gradual increase in running activities.
References:
Clinical Primer of
Rheumatology, Lippincott Williams & Wilkens, edited by William Koopman, et al., 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Last Editorial Review: 2/29/2008
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