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Ester Marsh column: How to avoid and treat shin splints

After great feedback on last week’s column on stress fractures in the foot, I figured I would continue the awareness of overuse injuries. This week, I am going to cover shin splints.

Shin splints are medically known as medial tibial stress syndrome (tibia is the shin bone in your lower leg) or in other words “too much too soon.” Shin splints typically happen to people who start from nothing and exercise too hard. It could be someone new to exercise who goes from a couch potato to 5-7 days of intense exercise. Or, it could be an athlete (especially right now with cross country athletes) from recreational running to competitive training or even racing. Many times, new recruits in the military, and both of my daughters can attest, say if you don’t have a good base condition, you are in for a rude awakening. Too much too soon will plague these soldiers with shin splints in many cases. As with stress fractures in the foot, shin splints can be caused by wearing the wrong foot wear, flat feet or high arches.

When I was accepted at the CIOS (Central Education of the Leaders in Sports Education), I went from doing a lot to doing an enormous amount of exercise and running. Not only that, but I had “plain Jane” sneakers. At this sports college in the Netherlands, we had to be in uniform and the shoes we had to buy were the original Nike Waffle sneakers. I remember the first time I put them on — I felt like I was walking on clouds! However, for all that we had to do, it was really hard on my legs and I got a severe case of shin splints, or as we say “periostitis,” which is Latin for medial tibial stress syndrome. It has been almost 30 years and I still remember the pain and throbbing. Over time I have found that “cushiony” shoes do not work for me. I literally will get an instant case of shin splints.

I also wear compression sleeves when running to prevent shin splints. It has made a huge difference. Before, when I would slowly increase, I would get shin splints in a heartbeat. So, with the right kind of shoes and wearing compression sleeves, I have figured out how to avoid shin splints.

Have you just started and are increasing your jumping activities? Running intensity too much too soon?

Have you been diagnosed with flat feet or high arches? The right shoes and/or the proper orthotics can prevent shin splints. Maybe you went from running on a treadmill to roads or run on uneven terrain such as trails. And another culprit for shin splints is doing hill work too hard too soon. Maybe you play sports on a hard surface. For the ones who are going into the military, get ready before you go to basic combat training. When you have a good base condition, your chance of shin splints and/or other injuries gets smaller. The better shape you are in before you go, the better off you will be.

When people tell me they have aching of the lower legs, I always ask if they have changed something (typically they have). If they let me touch their leg, I will press gently on the inside of the tibial (shin) bone. If you have shin splints, this area really hurts. Sometimes, there are a lot of bumps and tender spots on the inside of your shinbone.

As always, I feel you should have a doctor diagnose this overtraining injury. Your lower leg pains can be something completely different. If you know you have done too much too soon, rest your body — it needs time to heal. Ice your shins to ease the swelling and pain for 10-30 minutes every 4 hours until the pain is gone. If your doctor has approved, take an anti-inflammatory such as ibuprofen or Aleve. If you feel you didn’t do too much, have your feet checked — you might need new shoes. Maybe you need orthotics or start wearing compression sleeves. Some of our athletes have stopped wearing compression sleeves and the shin splints return.

Work on your flexibility. Many times, it is an imbalance between the front (tibialis anterior) and the back (calf –gastrocnemius muscles) of the lower leg muscles and tendons. Do flexibility exercises such as swimming or biking to give your shins a break. When you return to running, jumping or playing ball, increase your time or miles no more than 10 percent weekly. Give your body a break and start slowly. Increase the intensity, distance or frequency incrementally each week and you should be OK!

Ester H Marsh Associate executive Director JF Hurley YMCA

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