What are Shin Splints?
One of an aspiring runner’s early season setbacks, shin splints, can be prevented in most people.
Shin splints are a relatively common injury, estimated to account for 10-15% of all running injuries. We classify shin splints as an overuse injury, meaning they happen due to repetitive patterns on underprepared muscles.
Shin splints occur when your feet and lower leg muscles aren’t ready to handle a new or sudden increase in load. This can happen with middle school and high school athletes starting a new sport like tennis, dance, basketball, or track. It can also happen with adults who are starting a running or exercise program that doesn’t include enough time recovery and mobility work.
Shin splints can also happen to people recovering from surgery or those who have started a standing job and are standing or walking more than before.
Shin splints can feel like a dull or sharp ache, typically with a step, and is generally worse after activity. This pain will generally be on the lower part of your leg or front of your shin bone. The pain can come and go, but it will more persistent.
If you’re worried you might be experiencing the onset of shin splints, first, don’t panic. Then, try to immediately reduce the amount of time you’re spending on your feet. Stretching your calf and hamstring muscles can provide some relief, as well as wearing flat (ideally cushioned) shoes for at least a week.
With quick attention to shin splints, you can typically alleviate symptoms and get back to a running routine.
7 Strategies to Prevent Shin Splints
Use these general guidelines to reduce your risk of shin splints and get you back to your activity.
1. Learn to Move your Toes
Toe Exercises, also known as intrinsic footwork or ‘foot yoga’, can help you build up foot strength and improve your foot’s ability to absorb impact. Our feet have a mental map similarly to our hands (the homunculus), and with training, we can train our feet to move better.
Some exercises to try:
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- Toe Swaps: Can you pick up your big toe while keeping the other toes down?
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- Can you pick up all your toes individually from each other?
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- Towel Raise: How quickly ca you scrunch a towel in using just your toes and keeping the ball of your foot and heel planted?
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- Ankle movement: can you spell the alphabet with your feet? Can both feet do it just as easily?
2. Practice Impact
If you haven’t done plyometric exercises in a while (jumping, skipping, running), practice jumping in a controlled environment, like your home or the gym. Work on sticking your landing and other plyometric drills like broad jumps, box jumps, and single leg hops to help your brain and body be ready for running. Running could be considered a series of single leg jumps, so starting inside
3. Train on Soft Ground
If possible, start your running training on soft ground like fields or dirt trails. Running on pavement and concrete adds impact to your feet and running in the sand adds resistance, both surfaces can increase odds of developing shin splints for inexperienced or out of season runners.
4. Build up to Running
by strengthening your hips, glutes, and ankles. Adding exercises like lateral band walks, glute bridges, reverse lunges, and single leg balance drills help build strength in your muscles and improve your coordination.
5. Monitor your Volume:
Tracking the total amount of time in high impact (running, high-intensity sports, group fitness classes, etc), can go a long way in making sure you have a good progress plan to prevent shin splints. A good rule of thumb is to not increase your weekly volume by more than 10%.
6. Use Mobility Tools & Rest:
Foam rollers and lacrosse balls are great tools to help you release tight muscles at home and help your body be prepared for a run. Using a lacrosse ball to roll your feet and your calves and a foam roller to roll your quads, hips, and upper back, are a good practice.
Another couple of great self care practices for sore feet?
Epsom Salt Soaks can ease pain and inflammation (although is not generally recommended for those with diabetes).
Deep Tissue Massage can help release foot tension and other muscles, such as hamstrings, calves, glutes, and quads, that could be contributing to muscle pain.
Parrafin Wax treatment as seen in our Rehabilitation clinic as a modality to help relieve hand pain and improve mobility, is offered with many local pedicures.
7. Ask Somebody!
Whether a physical therapist, personal trainer, or or another professional, investing in a consultation or a couple months of services to learn how to help your body move well can set you up for a lifetime of good practices, reduce risk of injury, and more time doing what you want to do.
Use these general guidelines to reduce your risk of shin splints and get you back to your activity.
What if my pain doesn't go away?
If you have shin-splint type pain that doesn’t get better with rest (time off your feet),
Monitored Your Volume Correctly
Time standing at home to do the dishes, on the sidelines watching your kids game, or at work, does count towards your total volume for the day. Wearing a step tracking device can help you identify if you’re underestimating the total load on your feet.
If you don’t have the option of sitting out life activities and find you’re still on your feet quite a bit, bringing a chair with you or adding a padded foot mat to areas like the kitchen sink, laundry room, or your work desk can help.
Evaluated your shoe wear
High-heels, heavy boots, thin-soled sandles, or almost ill-fitting shoe can exacerbate the effects and prolong the duration of your shin splints.
This doesn’t mean you have to put away your favorite pair of shoes forever, but continuing to wear shoes that add weight or strain on your calves and feet without supporting your impact is the last thing shin splints need.
Invest in a pair of comfortable flats and get a shoe-fitting at a local sports shoe store. Many shoe stores, particularly those targeting runners, have gait-analysis devices that can help inform your shoe selection.
Addressed your Hydration and Protein Intake
Dehydration and low protein diets can delay your recovery and pain relief.
Water is essential for various bodily functions, including maintaining proper blood volume and circulation, lubricating joints, and supporting cellular processes. When you’re dehydrated your body isn’t functioning optimally and can have increased sensitivity to pain.
It’s estimated that up to 75% of American are dehydrated, and disruptive symptoms can range from mild to severe. Try carrying a water bottle or setting specific hours in the day to get up and drink a glass of water. When severe, dehydration can lead to cramps, muscle spasms, and headaches, which can compound existing pain.
Protein is another essential nutrient to help speed muscle recovery. Proteins are essential for tissue repair and in pain modulation.
After exercise or injury the body begins to make new protein to repair the damaged tissues. High quality protein containing essential amino acids provide the building blocks for this repair process.
Additionally, proteins like Tryptophan and Tyrosine are two essential amino acids involved with pain.
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- Tryptophan, an amino acid found in protein-rich foods, is a precursor for serotonin, a neurotransmitter involved in mood regulation and pain perception.
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- Tyrosine, another amino acid, is a precursor for dopamine, norepinephrine, and epinephrine, which play roles in pain modulation among other functions.
See a Specialist
Address lifestyle factors that might be making pain worse and resting your feet is your first step feeling better.
If your pain persists more than a couple of weeks, make an appointment with a local specialist. Your specialist can help you rule out other conditions or pain-causing pathologies and expedite your path to feeling better.
Some conditions that may present like shin splints that your foot surgeon can rule out include:
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- Tendonitis
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- Stress fracture.
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- Compartment syndrome.
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- Nerve entrapment
Additionally, the sooner you see a specialist, the better baseline you’ll have for managing a current pain episode up and any future flare ups. Your specialist can also identify additional supportive options, such as compression socks or prescription medications to help manage persistent symptoms.
If you’re local to Connecticut or Rhode Island and experiencing foot pain, make an appointment. We’re the proud home of Foot and Ankle Fellowship Surgeons, Dr. Emily Vafek or Dr. Nicole Arcand, who will help you get back on your feet.
Additional Resources
Bhusari, N., & Deshmukh, M. (2023). Shin Splint: A Review. Cureus, 15(1), e33905. https://doi.org/10.7759/cureus.33905
Deshmukh NS Jr, Phansopkar P, Wanjari MB. A Novel Physical Therapy Approach in Pain Management and Enhancement of Performance in Shin Splints Athletes: A Case Report. Cureus. 2022 Jul 9;14(7):e26676. doi: 10.7759/cureus.26676. PMID: 35949752; PMCID: PMC9358988.
Shell, W. E., Pavlik, S., Roth, B., Silver, M., Breitstein, M. L., May, L., & Silver, D. (2016). Reduction in Pain and Inflammation Associated With Chronic Low Back Pain With the Use of the Medical Food Theramine. American journal of therapeutics, 23(6), e1353–e1362. https://doi.org/10.1097/MJT.0000000000000068
Rompe JD, Cacchio A, Furia JP, Maffulli N: Low energy extracorporeal shock wave therapy as a treatment for medial tibial stress syndrome. Am J Sports Med. 2010, 38 (1): 125-132. 10.1177/0363546509343804.
Waldorff EI, Christenson KB, Cooney LA, Goldstein SA: Microdamage repair and remodeling requires mechanical loading. J Bone Miner Res. 2010, 25 (4): 734-745
