Most people know when they have shin splints, but very few—experts included—know what they are. Most doctors prefer the terms tendinitis, or periostitis, though they can’t say for certain which of those terms, if either, actually describes the condition. Some say shin splints are the start of a stress fracture. Others contend they are a muscle irritation. Still others think they are an irritation of the tendon that attaches muscle to the bone. The symptoms of shin splints are often confused with those of stress fracture. But shin splints typically include pain in the shin of one or both legs, though there may or may not be a specific area of tenderness. Pain and aching will be felt in the front of the leg after activity, although it may occur during activity as the condition progresses. MORE: 10 Reasons It Hurts When You Walk—And How To Feel Better Fast The shin splint treatment ideas here are designed to help keep that shin splint condition from progressing to the point of stress fracture and to let you continue your active lifestyle without causing undue harm. Let pain be your guide. If anything recommended here causes increased discomfort, don’t do it.
Take A Break
If walking or running is giving you shin splints, cut back for 3 to 8 weeks to give the tissues time to heal. Keep in shape by cross-training with low-impact exercises such as cycling or swimming. When you’re ready to walk or run again, go on a dirt path and limit it to 20 minutes at a moderate pace. Increase your distance or speed slightly each week. If you feel sore again, dial it back for a few days, and when you resume again take it even more slowly. MORE: 19 Pool Exercises You Have To Try
Start With The Ground
Hard, unyielding surfaces can produce shin splints in an instant. “Start by looking at the surface,” says athletic trainer Marjorie Albohm. “If you’re walking, running, dancing, playing basketball, or whatever on a surface that has no give, then you need to change that.” For people involved in aerobics, injuries are highest on concrete floors covered with carpet, while wood floors over air space are the least damaging. If you’re doing aerobics on a nonresilient floor, make sure that the instructor teaches only low-impact aerobics or that high-quality foam mats are provided. For runners, choose grass or dirt before asphalt, and asphalt before concrete. Concrete, however, is the hardest on your legs and should be avoided. Depending on where you live, you might have the best of both worlds—soft sidewalks. More than 140 cities in 28 states, including Washington, D.C., and Seattle, have installed sidewalks made from old car tires called Rubbersidewalks. This product was invented by a California-based company as an environmental measure, but the added benefit is decreased impact and a more forgiving landing should you take a spill.
Then Move On To The Shoes
If you can’t change your surface, or if you find that’s not the problem, look at different footwear. Choose a shoe with good arch support, shock absorption, and fit, says Albohm. For people who participate in activities that cause a lot of forefoot impact such as aerobics, judge a shoe on its ability to absorb shock in that area. The best test is to try the shoes on in the store and jump up and down, both on the toes and flat-footed. The impact with the floor should be firm but not jarring. For runners, the choice is a bit more difficult. Research has shown that about 58% of all runners with shin splints also pronate excessively (meaning the foot rolls to the inside). Choosing a shoe for pronation control sometimes means less cushioning. If you’re a pronator with shin splints, motion-control shoes are probably what you need most. These shoes are rigid and durable, and they limit pronation. (Try this simple test to find out your foot type—and choose the right shoe for your type.)
Change Shoes Often
One way to get as much cushioning as possible in your shoes is to change them frequently. Runners should replace their shoes every 300 miles, says Gary M. Gordon, DPM. Less mileage means new shoes once a year. People who participate in aerobics, tennis, or basketball twice a week need new shoes two or three times a year, while those who participate up to four times a week need them every 2 months.
Put It On RICE
As soon as you notice shin splint pain, follow the rules of RICE: rest, ice, compression, and elevation for 20 to 30 minutes a day. The experts swear by this as a simple shin splint treatment. Keep your icing routine simple, Albohm says. Just prop the leg up, wrap it with an elastic bandage, and place the ice pack on it for 20 to 30 minutes.
Go For Contrast
A variation on the RICE treatment is the contrast method, which seems especially effective for pain on the inner leg. With this method, alternate 1 minute of ice with 1 minute of heat. Do this before any activity that can cause shin splint pain, and continue it for at least 12 minutes.
Master Massage
“For shin splints in the front of the leg, you want to massage the area right near the edge of the shin—not directly on it,” says masseur Rich Phaigh. “If you work right on the bone, it just seems to make the inflammation worse.” To massage away shin splint pain, sit on the floor with one knee bent and the foot flat on the ground. Start by lightly stroking both sides of the bone using the palms of your hands, gliding them back and forth from knee to ankle. Repeat this stroking motion several times. Then wrap your hands around the calf and, using the tips of your fingers, stroke deeply on each side of the bone from ankle to knee. Cover the area, using as much pressure as possible. “What you want to do is restore length and relieve tightness in the tendons at the top and bottom of the shins,” Phaigh says, noting that a good massage helps improve circulation in the area, too. MORE: 2 Moves To Treat And Prevent Shingles
Correct Faulty Feet
Flat feet or very high arches can sometimes cause shin splints, Gordon says. “If you have flat feet, the muscle on the inside of your calf has to work harder and gets fatigued quicker,” he says, “making the bone take more of a pounding.” If you’re flat-footed, you may need additional shock-absorbing material or arch support in your shoes. Inserts are available at sporting goods stores, but it might be best to see a podiatrist before adding inserts on your own. Pain on the outside of the lower leg is sometimes associated with very high arches, Gordon says. “Relieving pain requires a lot of stretching exercises, as well as strengthening the muscles and maybe adding orthotics.”
Stretch Those Calves
Stretching the Achilles tendon and the calf muscles is an excellent preventive measure for shin splints, Albohm says. “If you’re a woman wearing 2-inch heels every day, you’re not stretching either of those at all.” Stretching helps, because shortened calf muscles tend to throw more weight and stress forward to the shins. Place your hands on a wall, extend one leg behind the other, and press the back heel slowly to the floor. Do this 20 times and repeat with the other leg. Here’s one more stretch for your calves: Stand on a curb and hang your heels over the edge. It’ll relieve the tightness across your shins.
Tend To Tendons
Gordon offers this simple technique for stretching the Achilles tendon: Keep both feet flat on the ground about 6 inches apart. Then bend your ankles and knees forward while keeping your back straight. Go to the point of tightness and hold for 30 seconds. “You should feel it really stretching down in the lower part of the calf,” he says. Repeat the exercise 10 times.
Strengthen Your Muscles
To help keep your shin splints from coming back, strengthen the muscles in the front of your lower leg, the anterior tibialis, with this simple exercise. Stand and lift your toes toward your shins 20 times. Work up to three sets. After that, to add resistance, place a 2- or 3-pound ankle weight across your toes.
When To Call A Doctor
Because some experts believe shin splints may actually be stress fractures in an early stage, telling the difference between the two is sometimes tricky. Even so, shin splints can become full-blown stress fractures with continued abuse, so seeing your doctor for an early diagnosis is crucial. “With a stress fracture, you’re going to have pinpoint pain, about the size of a dime or quarter,” says trainer Albohm. “If somebody asks you where it hurts, you’ll be able to go right to it, put one or two fingers on it, and tell them exactly where it is. It’ll be right on or around a bony area, and it’s point-specific. A shin splint will be an aching discomfort up and down the whole lower leg.”
Panel Of Advisors
Marjorie Albohm, is a certified athletic trainer and president of the National Athletic Trainers Association in Dallas. She served on the medical staffs for the 1980 Winter and 1996 Summer Olympics and the 1987 Pan American Games. Gary M. Gordon, DPM, is chief of podiatry at the University of Pennsylvania Sports Medicine Center and has a sports medicine practice in Glenside, Pennsylvania. Rich Phaigh is the owner of a therapeutic massage clinic in Eugene, Oregon. He has taught more than 250 classes in advanced therapeutic techniques in the United States and abroad. He has worked on the likes of running stars Alberto Salazar and Joan Samuelson.
