Have you ever dealt with nagging shin pain that limits you in skiing and running? You’ve tried resting it, but as soon as you started training again, the pain comes right back? Are shin splints even something you should be worrying about? Or maybe you’ve already been diagnosed with shin splints and told to take more time off. As an athlete, nothing is more frustrating!
In our sports physical therapy clinic, we see this type of injury too often. The good news, is that there are ways to manage and prevent shin splints. In this blog post, Zuzana Rogers, a sports specialist PT provides answers to questions you may have such as:
- What are shin splints and why do they happen?
- Is the “fix” as simple as stretching? (Spoil alert: the answer is NO!)
- Are there any hidden culprits to developing shin splints?
- How to prevent, recognize, and manage shin splints
- Are shin splints even a big deal?
What are shin splints and how do they happen in the first place?
Shin splints (or tibial bone stress syndrome) happen when the pull of the muscle exceeds the capacity of the bone to resist, leading to local inflammation and pain, most commonly on the inside edge of the shin bone, the tibia. (AKA too much activity, too soon.)
Pre-season athletes, people new to fitness programs, or those who have a sudden change in training intensity are at a high risk due to this. The condition is very common for youth runners and cross-country skiers, especially in athletes with low body mass index.
Is the "fix" as simple as stretching?
Oh man, does this one hit a PT’s funny bone! Unfortunately, you can not stretch your way out of shin splints. This goes back to the fact that shin splints are caused by too much load, too soon. The better bet is to put more focus into a progressive training schedule. If everything goes as it should, the body adapts to training loads and we get stronger, faster and more resilient. We feel bulletproof and ready to conquer the world!
When this balance is disrupted, you may start noticing nagging injuries that creep up and never really go away. At Runners’ Edge Alaska, we strive to find out where the balance has been disrupted and help you so you can return to running, skiing, and things that you love to do.
A hidden culprit: RED-S
One of the culprits to developing shin splints is Relative Energy Deficiency Syndrome (RED-S). RED-S describes a clinical syndrome resulting from energy deficiency. It happens when there is an imbalance between dietary energy intake and energy expenditure required to support normal bodily function, regular activities, growth and sport.
RED-S is formerly known as the Female Athlete Triad. It affects many aspects of physiological function such as bone growth and healing, hormonal balance, immune system, concentration and mental energy. In other words, when the demand for the body to expand energy is larger than the energy going in (calories form of food), the body goes into a self-preservation mode and ‘takes’ the energy from somewhere else – the menstrual period gets irregular and sometimes disappears, the bone loses its mineral density and microfractures happen.
So, if you are dealing with shin splints, have a closer look at how much you are training, how well you recover and how well you eat to fuel your training. Because if left untreated, shin splints can progress to bone stress injury and stress fractures.
6 ways to prevent, recognize, and manage shin splints
- Training – make sure the progression is gradual and consistent. This means that if you are a runner, you have to maintain some form of running shape during the off-season. Bone stress injuries can happen when there is a sudden increase of training that the body has difficulties to manage.
- Eating well – if your training load increases, make sure the meals follow! Make sure you get plenty of energy in your food
- Sleep – get plenty of Zzzz’s – this is one of the best recovery methods after exercise
- Vitamin D supplementation – this is the most legal form of performance enhancement! Great for bone health, immune system, recovery, and many other aspects of well-being. Consult your medical provider for the exact dosage.
- Check your form & footwear – Make sure your running technique and footwear is optimal. Your physical therapist can assess your running technique and recommend appropriate shoes.
- Track your cycle -For girls – if you miss your menstrual period for 3 or more months or your periods become irregular, please talk to your parent, PT, pediatrician, or parent. This is a red flag but there are ways to get back on track!
If you are dealing with a bone stress injury:
If left untreated, shin splints can develop into bone stress injuries. If you are dealing with a bone stress injury:
- Depending on your symptoms, you may need to see a physician, dietician, physical therapist and/or sports psychologist.
- Optimizing the energy availability is the core of treatment. You really need to maintain a high intake of nutritious food — it can’t be potato chips and brownies.
- If you have adequate nutrition to compensate for the energy you are expending, things should reset with time and go back to normal.
Shin splints are a big deal
Here is the big deal – many times, shin splints are not ‘just’ a muscle injury. It is a part of a bigger picture. At Runners’ Edge Alaska, we specialize in helping athletes overcome sports injuries. Feel free to email us/ call us for more information or sign up for a free discovery session today!
Resources and suggested readings:
- https://www.uwhealth.org/health-wellness/red-s-syndrome-what-atheletes-need-to-know/51699
- https://bjsm.bmj.com/content/48/7/491.short
Since we don’t know you and we can’t perform a detailed examination; responses are general tips only and not medical or physical therapy advice. If you need detailed answers to your questions, please contact us directly.
Written by:
Zuzana Rogers, PT, ScD, SCS, COMT
