What causes shin splints?
Shin splints are a common overuse injury and present in two forms (anterior and posterior shin splints), Anterior shin splints are the most common and are often seen in young athletes who have rapidly accelerated their training programs. This disease is located on the anterior lateral aspect of the tibia or (shin bone). This anterior shin splint will often resolve with proper physical therapy, anterior muscle group strengthening and team partner stretching programs. It is very common to see anterior shin splints develop in football players during “Hell Week” as they begin two-a-day football practices.
Distance runners generally develop posterior tibial tendon shin splints. This type of shin splint causes pain along the posterior medical area of the tibia (shin bone). This develops from chronic overuse and can be exacerbated by poor shoe choice and excessive pronation along with mechanical dysfunction. Proper running shoes, shoe condition, orthotics and strengthening exercises assist with recovery. We use products such as Theraband or elastic training bands to perform high repetition, low resistive exercises directed by your physician or physical therapist and athletic trainers. I recommend alternating running shoes on a day-on / day-off regimen. Typically we will use shoes for approximately 300-500 miles before they are discarded. I recommend bringing a new shoe into your regiment when your original shoe has approximately 175 miles logged on them. In this way your shoes will last longer as the EVA has a day to regain its “loft” and you are using a shoe that is not brand-new or at its end of life on an every day basis. Also, alternating the training from trails to road to track can be beneficial. Your training cadence can also be a significant factor. Over striding has a very high correlation to posterior tibial tendon dysfunction and shin splints.
If posterior tibial shin splints are left untreated for prolonged periods of time an athlete may develop “tibial stress syndrome” which is a precursor to a tibial stress fracture. If you are not recovering from posterior tibial shin splints, I recommend getting X-rays and or MRI as these will be beneficial in making the diagnosis. The differences between tibial stress syndrome and tibial stress fractures are subtle and often misdiagnosed. These subtle differences are best diagnosed by a physician who is specifically trained in this area of expertise.
Tip: As a competitive collegiate runner and physician, Dr. Francis Clark has seen many athletes in his practice from our local high school and college teams. He has served as team podiatrist physician for two of our local Wasatch Front college teams, He has treated collegiate, Olympic and professional athletes in his career and is well versed in running injuries.