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Shin Splints: Considering Stability, Recovery & Pain Management

Shin splints... an all too common and annoying experience that runners and other athletes share.

So, what's the solution? Rest? Ice? Heat? Foot Orthotics? Stretch Your Calves?

Unfortunately, there isn't a perfect remedy for shin splints (a.k.a medial tibial stress syndrome). However, this article will discuss a few considerations when trying to improve your "shin splints."

1. The Importance of Hip & Trunk Stability

It is very easy to become focused on the location of your pain like a moth to a flame. When it comes to shin splints, many people focus only on their calves and shins with stretching and icing. This approach is not wrong (and will probably provide some benefit), but may not be addressing a larger contributor to your shin splints... poor hip & trunk stability

Your hip (gluteal muscles and others) and trunk ("core muscles") play a massive role in keeping your torso & spine stable over your legs. When people have weakness and/or poor control of these muscle-groups, they may not be absorbing the impact of running or hiking appropriately, which can lead to problems elsewhere in the body.

In the case of shin splints, poor hip & trunk stability may result in a runner's knee to cave inward during the moment of single limb stance (a.k.a dynamic knee valgus) which may bias their foot & ankle into increased-pronation (a collapsing arch) which places the tibialis posterior muscle (muscle often associated with shin splints) under large forces in a lengthened & unsupported position.

So, how do you improve your ability to stabilize your body with your hip & trunk (and ankle) musculature? A simple place to start is improving your single leg balance! Practicing these exercises barefoot is preferable, but not mandatory.

  • Level 1: Able to balance on one foot for 30 seconds without looking at ground

  • Level 2: Able to balance on one foot for 60 seconds without looking at ground

  • Level 3: Able to balance on one foot for 30 seconds with eyes closed

  • Level 4: Able to balance on one foot for 30 seconds on 1 to 2 inch-wide balance beam (tape on the floor, wooden dowel, broom stick, etc.)

  • Level 5: Able to balance on one foot for 30 seconds on your balance beam without looking at ground

***(For more information and inspiration regarding balance beam play/training, check out @TheFootCollective on Instagram!)***

2. Recovery Basics

When dealing with shin splints, many people will use rest and periods of inactivity to "get rid of" their symptoms of pain. Movement is crucial to promoting recovery and tissue healing! Sitting on the couch and watching Game of Thrones is a wonderful experience, but a horrible way to promote tissue-healing.

Low-impact, aerobic (cardio) activities like walking (if it does not increase symptoms), swimming, cycling, etc. can help improve blood-flow to the tissues that need to be repaired as well as remove cellular waste-products from tissue damage! 15-30 minutes of movement can be incredibly powerful.

In addition to keeping your body moving to optimize healing, sleep-hygiene is crucial. If you are struggling with quality sleep, check out our blog article, "5 Strategies For Better Sleep Quality: Your Foundation"

Icing is a common treatment-choice amongst people with shin splints. Ice can be a useful tool for managing symptoms of pain, but evidence suggests it may actually delay tissue-healing. If you do not NEED to use ice, it may be better to use modalities like gentle massage and foam rolling (if they help) to manage pain and discomfort without getting in the way of tissue healing.

3. "Know Pain, Know Gain"

"No Pain, No Gain," is a common phrase in our society, especially in the world of sport & athletics. As the field of pain neuroscience continues to improve our understanding of pain, this approach to pain and injury is not recommended. Although pain does not always indicate that their is damage to the tissues of your body, it is meant to be protective. When you keep pushing through severe-pain, your nervous system can become "overly protective" and make symptoms worse. This may also indicate a mismatch between training and tissue recovery.

Improving your understanding of pain is empowering and can help you keep your pain within appropriate levels. But what are "appropriate levels of pain?" It can be as simple as a traffic light!

  • Green Light (Go, Continue Activity): Pain is Minimal or Non-Existent

  • Self Rating of Pain Severity: (0-3 out of 10)

  • Yellow Light (Slow Down, Consider Changing Activity): Moderate Pain, Distracting

  • Self Rating of Pain Severity: (4-5 out of 10)

  • Red Light (Stop Activity, Active Recovery & Rest): Severe Pain, Decreases Performance

  • Self Rating of Pain Severity: (6-10 out of 10)

When participating in exercise/activity with pain, this green, yellow, red-light concept can act as a guide for when it is appropriate to continue, change or stop the activity. Try to keep your physical activity in the green and yellow-light zones and avoid the red to reduce the risk of flareups and setbacks!

Wrapping Up

  • Improve your hip & trunk stability! Single leg balance is a great place to start!

  • Active recovery is crucial to optimal tissue healing and ice is not as nice as we thought!

  • Keep your pain within appropriate levels, stay in the Green and Yellow Zones!

This article is far from an exhaustive list of treatment approaches and modalities for people dealing with shin splints. It is meant to be additive to your current treatment approach to your symptoms of shin splints.

Other Considerations:

  • Training Volume

  • Rate of Training Progression

  • Foot & Ankle Mobility/Range of Motion

  • Running Cadence, Foot Strike, Stride Length

  • Running Surface (roads, trails, soccer pitch, etc.)

  • Hiking Stride & Cadence

  • Downhill Hiking Technique

  • Body Weight

  • Shoes, Orthotics

  • Stress Management

If you need extra help due to lingering symptoms and/or severe pain, it may be appropriate to see your physiotherapist that can provide you with a comprehensive, movement-based assessment and individualized treatment plan.

Thank you for reading!

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