So, you have made the commitment. The commitment to exercise and get yourself in tip-top shape. You started running. You bought running shoes and are all set to go. Your first run goes well, you went further than you thought, almost a full mile. You are proud and excited, you can do this! And you do it, every day for a week. But then, it starts ….a pain and soreness in your shin. The pain is enough that you can’t keep running. You didn’t bump it against anything; you see no redness, no bruising, and no swelling. What it is?
While stress fractures to the tibia (leg bone) do happen after starting running programs and if you run long distances, the most common cause of pain in the front of the leg along and near the ‘shin bone’ is shin splints. Shin splints can be defined as pain and discomfort in the leg from repetitive running on hard surfaces or overuse use of the muscles that bring up the foot.
Aching, throbbing or tenderness along the inside of the shin or directly on the shin are the most common symptoms associated with shin splints. The pain is felt when the area along the tibia (shin) where muscles attach becomes inflamed. While more appropriately named periostitis, we will continue with the more common term known as shin splints. Another symptom is pain when you press on the inflamed area. Shin splint pain is most severe at the start of a run, and sometimes will go away during a run once the muscles are loosened up. On the contrary, a stress fracture of the tibia, shinbone, will hurt all the time.
The shin splints can result from tired or stiff calf muscles putting too much stress on tendons, which become strained and torn. Overpronation of the foot aggravates this problem, as does running on hard surfaces, and running in stiff shoes.
Beginning runners are the most susceptible to shinsplints for many reasons, but the most common is that they’re using leg muscles that haven’t been stressed in the same way before. Another reason beginning runners develop shinsplints is because of poor choices in running shoes or running in something other than running shoes. Those runners who have started running again after long layoffs are also at a higher risk of developing shinsplints because they often run too far initially on return.
Rest is the best treatment, with a slow return to normal activity so long as the pain is no longer present. Reducing the inflammation is key and can take from 2-3 days up to 2-3 weeks. Ice to the area two to three times per day, a course of anti-inflammatory medications, and stretching and strengthening exercises are useful along with rest. Some athletes who develop shin splints have flat feet (excessive pronation) which exacerbates the strain on the leg muscles. In such cases, the runner should obtain orthotic support, in conjunction with the strengthening and stretching exercises.
Finally, think about your running form. Are you leaning forward too much? Are you slouching? If you are doing any of these you may be putting too much strain on your muscles
If, after following the above recommendations, the pain continues, it is possible that micro-fractures may form in your tibia; these are stress fractures. You won’t have a sudden break, just a gradual increase in pain until it becomes quite severe. If you have extreme shin pain, see a doctor for an x-ray.
Shin splints are extremely common among beginning runners, whose enthusiasm for their new sport has over-stepped the limits of their legs. Take a look at your running program; you may be doing too much too soon.
Dr. Lori Lane is a founder and owner of LA Podiatry Group. With two offices in Wellington and West Palm Beach, Dr. Lane and her team of 6 physicians provide comprehensive foot and ankle care to residents of Palm Beach County at two offices, located in Wellington and West Palm Beach, six area hospitals, numerous nursing homes. LA Podiatry Group accepts most insurances and is happy to serve your foot and ankle needs.