No More Quick Fixes for Shin Splints

Stretching is crucial to the prevention of any running injury--including shin splints.

Running can be a person's greatest joy or biggest pain. The tremendous impact running places on the joints, muscles and bones requires your body to be in proper alignment.

If you run regularly, you may find that you sometimes develop a dull ache on the inside lower portion of your shin. It may get worse the more you run, walk or stand. Chances are you have a case of shin splints.

If you are one of the multitudes of recreational runners who has suffered from this very common overuse injury--you know firsthand how painful the condition is and how frustrating recovery can be.

Many runners consider shin splints to be one of the most painful and persistent conditions they can develop. Although the pain associated with it is due to chronic contraction of the muscle at the front of the leg (tibialis anterior), the cause of shin splints is usually related to improper biomechanics of the foot and knee.

Such a situation can cause a twisting of the shin bone, forcing the tibialis anterior muscle to work much harder than necessary. This twisting is called tibial torsion, and if left untreated can cause significant damage to the meniscus, the cartilage pad of the knee.

Conditions That Lead to Shin Splints

Shin splints usually start as stress reactions in the soft tissues and/or bones. The reaction can be magnified by any structural deficits in the lower extremities.

Over time and use, these deficits contribute to biomechanical stress that will exceed your bodys ability to adapt and /or repair itself. Structural deficits in the lower extremities include such conditions as:

  • Non-supported arches, or structurally compromised longitudinal or transverse arches, often called flat feet. This is a condition that is characterized by fallen ankles and jammed foot joints. With it, the impact of the foot is no longer absorbed by the ankle. Instead, the tibia and fibula (the two bones in the lower leg) start to absorb the impact. Once this begins to occur, the tibia and fibula rotationally torque the membrane that holds them together, creating inflammation and pain. The more you use a compromised limb, the greater the discomfort.

  • Overpronation. Your gait cycle involves your feet rolling in (pronation) and out (supination) when you run, walk or stand. Both motions are essential parts of your gait cycle, so its normal to have some of both. When the two parts of the gait are out of balance, you are at risk of injury. Most notably, overpronation can lead to heel pain, stress fractures, knee pain and painful shin splints.

  • Abnormal joint function. In runners who are not injured, abnormal joint function can affect the three phases of cadence. Consequently, joint movement is impacted, setting the stage for injury at some time in the future. By simply adjusting a joint that is not functioning properly, a future injury may be avoided.

Treatment Options

Most shin splint treatment plans teach you to stretch prior to running and ice post workout. Many also mention over-the-counter, non-steroid analgesics or similar pharmaceutical remedies.

Fortunately, such treatment plans can provide temporary relief. Unfortunately, they address only the symptoms and mask the real problems listed above. Here are three equally important concepts to prevent and treat nagging shin splints.

  1. Stretching: Active-isolated stretching as outlined in The Whartons Stretch Book by Jim and Phil Wharton is a great program specifically designed for running. The book covers the three phases of cadence (foot plant, push off and airborne) and explains that the ankle is the power generator and outworks your knee by 150 percent and your hips by 300 percent during the push-off phase. They cover it whether youre a marathoner or a sprinter.

  2. Support: Foot orthotics are recommended. Supporting your medial arch prevents the tibia and fibula from rotational torque during the foot plant phase of the cadence. The engineering behind most orthotics is exceptional.

  3. Chiropractic Evaluation: Have a qualified chiropractor evaluate your ankle, knee and hip motions. Normal body motion only occurs when the joints function properly, so correcting the underlying biomechanical cause of the pain is the only way to completely recover from shin splints. A trained chiropractor can determine the source of your shin splints and recommend a treatment plan that works for your running needs.

The best news is that you do not have to continue suffering form shin splints. Just imagine how free you will feel once the the pain is gone.

Dr. Roger Smith, D.C., is a chiropractor at Indigo Chiropractic in Scottsdale, Ariz. He can be reached at . Curt Blakeney is a freelance writer based in Arizona. He can be reached at .

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