Shin Splints

There's a lot of confusion over exactly what a 'Shin Splint' is. What are they and what causes them?

Originally, 'shin splints' was a term used to describe any prolonged or recurring pain that any sports person experienced, between the knee and the ankle.

The pain was due to an overuse injury; much like the term itself was overused!

Nowadays, we have a much more in depth knowledge of sports injuries and the phrase 'shin splints' is now used as an umbrella-term to include various lower limb conditions; such as compartment syndrome, stress fractures and medial tibial stress syndrome (MTSS). The latter of these is the most common condition that I come across occurring in weight-bearing sports where the players' feet are constantly striking the ground (basketball, football, dancing, long and middle distance runners). The pain occurs during exercise and subsides with rest. Most players decide to train through the pain because "it isn't that bad" but this only serves to worsen the condition and eventually it is impossible to walk without pain. At this point they probably have a stress fracture.

If you have experienced this type of pain, either after or during your exercise, you must first analyse any changes that you have made to your routine…new shoes? different surfaces? different route? different time of day you are training? The smallest of changes can often be responsible for bringing about major changes in your body's routine.

Looking at your training shoes is a good way to analyse how you are running. Do you run on the outside of your soles, the inside or more on the heels?

Think about the type of surface are you training on as well, because this has a significant bearing the type of condition you may have. If you regularly train on hard pavements or roads, especially where there is a slight camber in the surface…then stop. You need to vary the terrain. Running the same route week in week out can trigger MTSS, as can running too many hills. This may sound difficult to manage; especially with most footpaths and fields closed off at the moment, due to foot and mouth disease, but the key is variation. Vary where you run, how far, how fast and on what surface.

The most common condition occurs in novice runners, those trying to loose weight or get-fit-quick regimes, as well as experienced runners who return too soon after injury. The body does adapt to the demands you put on it, but not as quickly as most people would like. Be patient and build up these things gradually. The body responds to gradual exercise and it hurts when we apply too-much-too-soon-syndrome!

If you start to feel any of these pains in your lower leg, it could be the early warning signs of MTSS. Reduce the length of training time or running mileage and the pain should start to ease as your body adjusts.

There are many other factors that may pre-dispose you to these conditions, such as low calcium diet, menstrual abnormalities, muscle imbalances, inflexibility, genetic factors, insufficient warm-ups and others skeletal abnormalities.

References:
Noakes 'Lore of running' the science and spirit of running.Halliday 'Peak Performance'

Wednesday, 13 August 2003

© 2003 Bromley Health Management