shin splints

what are shin splints?

Walter Romero / Hispanic Attack

Shin splints, known as medial tibial stress syndrome (MTSS), is a broad term for pain in the front of the leg anywhere between the knee and the ankle that occurs with exercise. They are most commonly located on the medial side of the shin (toward the inside of the leg along the tibia, known as medial shin splints). Still, they can also occur toward the front outside of the tibia (anterior shin splints). They tend to be generalized pain (occurring over an area of several inches), as opposed to pinpoint pain. Shin splints result from cumulative stress rather than an acute injury, and the symptoms can develop and increase gradually. The cause of shin splints is multifactorial and often debated. The muscles on the front of the shin that lift the foot are encased in the fascia, a tough non-stretchy tissue. With exercise, the muscles also will naturally swell inside the fascia and this can cause pain. The underlying bone can also develop microscopic stress fractures contributing to the problem.

who is prone to shin splints?

Athletes that rapidly increase the amount of training they are doing, or change the surface or footwear that they use, can be prone to shin splints. Overpronators (people with flat feet) can also be at risk, along with people with weak ankle muscles or a tight achilles tendon. Derby players are at particular risk due to excessive stress placed on one leg and hip from always skating the same direction around the track.

treatment and prevention

Any athlete hates to hear this advice, but to heal ongoing problems with shin splints, it is often necessary to rest and even take some time off from your sport. Relative or “active rest,” switching to an activity like cycling or swimming that does not cause the shins to hurt, maybe a good way to go. Ice and anti-inflammatories can help, as well. Some skaters use foam or plastic rollers (like “The Stick”) to stretch the affected muscles. An orthotic in your skates can help the problem if you are an overpronator. There are also neoprene compression sleeves that are sold to wear on the lower leg, which some athletes have found useful. Tape or an Ace bandage may also wrap the lower leg. Physical therapy and stretches can help. Stretch the Achilles and calves regularly. Some have advocated walking on your heels for 30 seconds, alternating with walking flat-footed for 30 seconds, repeated for four or five minutes, several times a day, as a treatment and prevention strategy. Another stretch involves kneeling with the toes pointed straight back, then sitting back onto the calves and heels until tension is felt in the shins. It may be difficult to spend a lot of time in derby skating in the opposite direction, but trying to do so for cool-down at the end of a workout might help to even things up a bit.

when to return to activity?

Skaters with shin splints may need two to four weeks of relative rest to allow the chronic stress of shin splints to heal. They may take three to six months to heal fully. When resuming activity, it is important to do it gradually: start at less than 50% time and intensity, and work up slowly to your normal schedule. If pain resumes, it’s a sign to notch back. Warming up and stretching before exercise, and icing immediately afterward, can also help.

Not intended as medical advice. Consult your doctor with any problems.

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