With the big uptick in people using running as their key form of activity during these COVID times, we are starting to see flurry of shin splint and stress reaction cases pop up in the clinic.
What exactly are shin splints and how do they arise?
Shin splints are exercise-induced pain along the posteromedial tibial border (usually the distal third of the inside shin) caused by repetitive loading stress during running and jumping and is painful on touch.
They main contributing factor is load. This could be from an increase in distance, intensity and duration of your running. If we go from not doing a lot, and start doing it very frequently, our body goes under stress as it tries to adapt to the new load being put on it. Other contributing factors are running on a hard or uneven surface and bad running shoes (like a poor shock absorbing capacity). There are some biomechanical abnormalities as foot arch abnormalities, hyperpronation of the foot, unequal leg length which could also factor in. However, it usually all comes down to load. Sometimes your body adapts well and manages, while other times it is unable to keep up. In the case of shin splints, inflammation starts to build along the boarder of the inside edge of your shin between your tibia and the adjacent muscles. The result is pain and discomfort when we run, jump, even walk and is very tender to touch along the inside shin.
What is the management strategy?
The most important and modifiable factor which cause shin splint is load. While its not what most people want to hear, the most effective strategy to start alleviating your symptoms is to significantly reduce your running load for a period of time to let things settle down. This could be anywhere from 2-4 weeks depending on the severity.
HOWEVER, this doesn’t mean you’re doing absolutely nothing over that time of no to minimal running. There are exercises with low impact which the shins will be able to tolerate and a way for you to still stay active.
If you’re craving to get that heart rate up, then bike ergs and cycling are a great go to exercise modality which won’t flare up those shins. Strength training to help support structures in the lower limb and build resilience is also important to maintain. Glute, hamy and calf strengthening are key.
Then as those shins start to settle a graded loading exposure program to ease you back into running can commence to build you up back to full capacity.