Q. I developed shin splints about two months ago. I have tried insoles to correct overpronation, and ice to reduce swelling. Nothing seems to work. Can you help?
A. Shin splints is a term used to describe a variety of pains that occur in the front of the lower leg, along the tibia (shinbone) and the connective tissues that attach your muscles to your tibia. The medical term for this condition is medial tibial stress syndrome (MTSS).
It is considered a cumulative stress injury because it often develops after repeated stress or exercise without appropriate recovery between training sessions. The most serious form of MTSS is a stress fracture.
Muscle trauma is often related to overtraining or excessive running on hard surfaces. The muscles swell, putting pressure on the fascia tissue that covers the muscles in the lower leg, causing pain.
Other biomechanical issues, such as overpronation, have been linked to shin splints. It's a frustrating condition because rest is needed, and you risk re-injury if you return to training too soon. Change your routine, and cut your exercise time and intensity so that you have no discomfort before, during or after exercise.
The main causes of shin splints are training too hard and increasing your mileage too quickly. Running or jumping on hard surfaces will make things worse. Muscle imbalance between the back and front of the leg also plays a part.
Keeping an eye on your trainers is important; worn-out shoes that don't offer support, or shoes that are not right for your foot type, can cause shin pain.
Treatment must start with rest, ice and compression. Acupuncture, ultrasound or taping your shins can help with the pain, but strengthening and stretching, along with proprioceptive and balance exercises, will address the causes of the problem.
Ensure your trainers suit your foot type; consult a podiatrist for assessment for orthotic inserts. Returning to running must be done gradually. If shin pain continues after three weeks of self-management, consider seeing a physiotherapist. You may need to see a sports physician for further investigation.
Paula Coates is a clinical specialist sports physiotherapist (paulacoates.com) with 16 years experience in her field, treating both professional and non-professional athletes at a leading sports-injury clinic in London. She has completed eight marathons - three of them on inline skates - and is the author of four books, including Running Repairs: a Runner's Guide to Keeping Injury Free.