FYZICAL-ly Fit with Joe:
Preventing Shin Splints by Joseph A. Stroz, DPT, CSCS
As spring approaches, many junior high and high school aged kids start track and field practice, and many adults start to walk for exercise, and general well-being. Unfortunately, after long winter months, we have the tendency to be more sedentary due to the colder weather and shorter daylight. Generally leaving our bodies in less physical shape and being more vulnerable to increased soreness and even strain injuries to our muscle and tendons as we begin to start walking or jogging programs. One of the most common and painful injuries is what most people call “shin splints.”
This is described as when a person gets very sore in the anterior (front) aspects of their lower legs; this is usually noticed about 24-48 hours after their first bout of more volume miles or time spent walking and/or jogging. The condition is actually just the soreness of a long, thin muscle (anterior tibialis) that is generally only one of a few muscles that cover the front of your shin.
If you place your fingertips on the front of your shin and move your foot up and down while you are sitting at the edge of an elevated surface with your foot dangled (not touching the floor) you can feel the muscle bulge and flatten as you move your ankle up and down, respectively. The muscle is responsible for lifting your foot upwards as you advance your leg to take a step, and once the leg’s foot makes contact with the ground with the foot’s heel, this muscle then has to decelerate the speed of the foot until the foot is in full contact with the ground. This process is repeated over and over as we walk, and more so, in volume and aggressiveness when we do any form of running.
If there is a more intense soreness, the muscle (usually the interface of where the muscle is pasted along the outer shin bone) covering (periosteum) becomes inflamed and in some cases the small little fibers that connect the muscle to the bone (“Sharpey’s Fibers”) can become strained like in any injury. The condition can be treated conservatively with rest, manual massage, taping, and use of ice, then heat.
Usually after 1-2 weeks the pain is resolved, but can come back if a few things are not addressed:
1.) Proper strength exercises to prepare this muscle for the work it is planned to endure. See below for an exercise program.
2.) Proper stretching exercises to the actual muscle, but even more importantly to the muscles that oppose this muscle, to help reduce the work of it when it is in action. See below for an exercise program.
3.) Be mindful of starting your walking and jogging program with a less intense approach, such as starting on only flat surfaces for shorter distances/durations, then gradually increasing the difficulty over time to avoid overworking the muscles and tendons. A treadmill can be a good option if the weather is not ideal to walk outside but keep it flat and start with a slower belt speed.
4.) Use proper fitting and supportive shoes designed for walking and running.
5.) If you noticed, or have been told by a certified health practitioner, such as a physical therapist or podiatrist, that you have flat feet (reduced arches) or high arches, then getting fitted by a trained physical therapist or podiatrist with shoe custom orthotics or good quality pre-fabricated orthotics can help prevent abnormal forces to not only the lower leg muscles and tendons, but to our knees, hips, and spine as well.
Below are some easy, but effective exercises to perform 2-3 days a week or daily if you desire, for at least 2 weeks prior to starting your walking or running program to help prevent shin splints:
1.) Standing foot raises: Stand close to a wall, then lean your back against a wall, and your feet close to the wall. Slowly raise one foot upward toward the ceiling as far as possible, pause for a second, then lower twice as slow to the floor. Perform 10 to 20 times, then do the other side. Perform 1-3 sets of these.
2.) Standing calf raises: Facing a wall or while holding onto the back of a chair to balance yourself, slowly raise your heels off the floor, raising as high as possible while making sure all 5 of your toes are evenly pushing into the floor. Pause at the top briefly, then slowly lower twice as slow towards the floor. If you are able, perform this one leg at a time (holding non-working leg in the air like a flamingo bird), if this is too hard, then you can perform both feet at the same time, you just may need to do more repetitions to make it more challenging. Perform 10-20 reps and for 1-3 sets total.
3.) Standing calf stretch: Facing the wall, bring one leg forward and the leg being stretched placed extended behind the body with the knee straight. Keeping your rear foot flat to the ground and facing forward, slowly lean forward without lifting up your heal, feeling a light to moderate pulling sensation to the calf and Achilles tendon (lower aspect of calf muscle to the heal; hold this position without bouncing or moving for a duration of 30 to 60 seconds, then relax. Now perform the same exercise with the rear extended leg with the knee slightly flexed (bent); the stretch sensation will be a little less, but this is normal. Perform for the same time and do so without bouncing or moving. Repeat this on each leg for at least 3 cycles.
See below for the pictures of these exercises.
Have a happy and healthy week,
Joseph A. Stroz, DPT, CSCS
Senior Staff Physical Therapist/Owner of FYZICAL Therapy and Balance- Windber
*This is in no way a substitute for your physician's care, nor is it meant to replace your physician's advice. Always consult your physician when noticing any changes in your health and prior to any new activity.
