Shin Splints: The Pain You Shouldn't Run Through

Rest days. Some of us love them, some of us can't wait until they are over and our normal week begins. I fall in the latter category. Imagine my disappointment when my doctor told me to stay away from running and other impact exercises until my shin splints heal. I was devastated. No, it doesn't sound like the end of the world, but for a run addict it is worse than the end of the world. What do you mean I can't run? Are you insane? Cross training? Do you want to kill me with a teaser of an exercise without proper release of all this beast mode, pint up energy? No, no, no, no, no! Let me at it! Let me run! But alas, I had to listen to the doctor. There I spent  9 weeks in physical therapy, doing my exercises, not running or jumping or doing anything else that would aggravate my aliment. If being away from the road wasn't hard enough, the prescribed amount of running after the awful, long break was laughable. Start with a mile and build up by a mile every week. That is for a person who began her half marathon prep! I was going nuts! Running that one mile for the first week was equivalent of eating just one Hershey Kiss -- frustrating. You just get a taste of how awesome this run is going to be and then you have to stop and go home, it wasn't even a warm up! Regardless of my frustrations, I did as the doctor told me. I built up slowly, continued my therapy exercises, stretched, rolled, iced, took anti-inflammatory medication, invested in new shoes and insoles,  took my calcium and vitamin D and up until recently was enjoying a fairly pain free running existence. The key words here are "until recently".  On Tuesday of this week I came home after my metabolic workout, took off my compression calf sleeves, and found a large, purple bruise set a few inches above my ankle. The first thought that went through my mind was: "Oh, no! Not a shin fracture!" The second was: "I have to get to the bottom of this! I can't keep having my running goals derailed by my body." I immediately went to go look for a highly rated podiatrist in my area and made an appointment for Monday afternoon.  In the mean time, I decided to do extensive research on my incredibly frustrating, shin splint condition. 

What are Shin Splints?

Medial Tibial Stress Syndrome (MTSS) is commonly known as "shin splints" and is  one of the most common lower leg injuries among athletes and dancers.  Shin Splints occur when the tibia and the surrounding muscles undergo repeated stress and do not have time to properly heal and recover from repeated muscle contraction and strain. MTSS usually presents as a dull, wide spread pain along the inside of the lower leg (middle-distal tibia) during impact exercise. In the early stages of MTSS the pain is worse at the beginning of exercise and subsides as the exercise progresses. I know some runners out there are saying to themselves right now: "pssht, I'm a runner! Pain is part of our existence especially if it dissipates as I warm up!" Don't be fooled! Although the pain might temporarily subside, continued aggravation of an overuse injury can lead to serious consequences like stress fractures and mild to severe pain that does not subside with cessation of exercise at sometimes persists even at rest.

 

How did I get Shin Splints?

In short, I don't know. MTSS is a very personalized injury that can be caused virtually by anything from improper form to your genetics.  In most cases MTSS is caused by improper form, an unusual increase in exercise or a sudden change in exercise surface (i.e. changing your running surface from trail to pavement). Inadequet nutrition can also be a contributing factor to MTSS especially in the cases where shin splints are a reoccurring injury. Bio-mechanical abnormalities such as: knee abnormalities, tibial torsion, ankle abnormalities, foot arch abnormalities, femoral anteversion can all put a person at risk for MTSS. Your doctor should perform a plethora of necessary tests to determine what the contributing factors of MTSS are in your case. 

So, What Do I Do Now?

Regardless of the cause, shin splints are an overuse injury and should be treated with rest. Most doctors will recommend that you decrease or stop all impact exercises for a period of 2 to 8 weeks. Other treatment methods like anti inflammatory medication, ice, physical therapy, or dry needling might be recommended.

Is There a Cure for Shin Splints?

Yes, there is a cure. Rest and retraining. If your doctor and PT (physical therapist) have determined that you have bio-mechanical imbalances, you need to fix them as soon as possible.  For example: most runners seem to have weak glutes. If that is indeed the reason you seem to overuse your lower leg, then you need to train your glute and hip complex to offset the load and so on. The most successful way to prevent MTSS is to address the reasons why it happened in the first place. So, if your form and muscular development is the problem, you need to get a running coach or a trainer and make sure that you learn the proper way to run/ train in order to prevent further flare-ups.

But if I can't Run I'll Wither Away and Die!

I use to think that too. I use to hate every hour that went by when I couldn't go out there and run. I whined, I cried, and I was a very unpleasant person to be around when I was not logging regular miles. However, I did find an alternative to running that was not as good as the real thing, but in a pinch.... The day I found pool running I became a nicer person. No, it is not the same as going out there and feeling like a total badass while leaving hill after hill in your rare view, but it is something. Pool running works the same muscles as regular running but without all the impact. So, if your doctor and PT tell you not to run,  ask them about pool running. 

Shin Splints can be extremely annoying and inconvenient but only if you let them. Just like dealing with any other sports injury, you need to look on the bright side, take the time to develop in other areas that you might want to use in the future. For example, if you know that you might want to do a triathlon in the near future, pick up biking and swimming. If lifting weights is your secondary passion challenge yourself to beat your max. Under no circumstances remain unoccupied.  Forced inactivity can hurt more than the injury and lead to devastating results. So, if you are stuck with shin splints, concentrate on getting yourself better, do not skip PT sessions, do not push yourself to run through the pain, and most importantly get off the couch and go to the gym/ pool/ bike trail.