In September, we are beginning a new column where we ask health practitioners to help us understand a bit more about some common questions and concerns we hear from our members.  This month, we tackled shin splints.

This month's contributor:

Adam Tenforde, MD is a resident in Physical Medicine and Rehabilitation at Stanford Medical Center.  He is a 2010 recipient of the prestigious New Investigator Researcher Grant, awarded annually to the top 2-3 PM&R residents nationwide.  His recent work includes the co-written paper, Overuse Injuries in High School Runners: Lifetime Prevalence and Prevention Strategies.

While an undergraduate at Stanford, Adam earned five All-American awards, and took part in three NCAA team championships before concluding his collegiate running career with a 9th place finish in the 10,000 meters at the 2004 Olympic Team Trials.

AT: Shins splints are also known as medial tibial stress syndrome and are the most common leg injury in athletes. Basically, they are defined as pain located along the shinbone.  The pain tends to be diffuse over at least five centimeters, and it is thought to be caused by inflammation on the periostium (the sheath around the bone). Excessive forces can cause the bone to be pressured without adequate time for recovery, which results in little micro damages to the sheath. These result in pain and inflammation.

Risk factors include excessive pronation, and shin splints are more common in female runners.  As with most running injuries, it is a question of doing things in a gradual way so the body can react.  Increasing frequency, volume, or intensity of training, along with improperly fitting footwear or worn out shoes can cause problems, as can extensive running on hard surfaces.

Coach: What are a couple things we can do to help prevent them?

AT: The first thing is to understand what they are.  Then you know what stresses you are putting on your body.  Consider the age and appropriateness of your shoes and review your training to make sure you aren’t making any huge sudden jumps.   Many runners with shin splints also report tight calves and relatively modest strength in the lower leg muscles. Proper stretching and strengthening of the calf muscles can help.   One productive exercise is heel walking.  [Check out our Heel Walking Demo Video here.]

Coach: If we feel shin splints coming on, what should we do?

AT: There is an inflammatory component here, so ice can help a lot.  A reduction in training intensity and a change in running surfaces may be required to allow the symptoms to subside.  Anti-inflammatories may be appropriate, but consult your physician to ensure they are a safe choice for you.  If symptoms persist or become steadily worse, make an appointment with your doctor.