View Full Version : Medial Shin Splints
Hello,
I suffer from medial shin splints during and especially after sprinting short distances without stretching. The pain is centralized around the mid-calf, but the 'center' varies in each instance. I over-pronate, which I correct with custom orthotics and New Balance running shoes.
I was wondering- aside from Ibuprofen, is there any way of treating and preventing these kind of shin splints? They generally don't happen when I stretch, but I never have time to stretch when running to catch the bus :)
Thank you for your help, I would be glad to provide any further information.
Solid
Sacamuelas
05-11-2004, 08:56
Originally posted by Solid
is there any way of treating and preventing these kind of shin splints? They generally don't happen when I stretch.
Solid
Asked and answered. Tx is to STRETCH. There is no cure better than prevention.
Here is your custom Rx... Set that "SF watch" of yours to wake you up 2 minutes earlier than you normally do and then stretch.. take the other 60 seconds of that time and thank yourself for doing it and admire how cool it is to have a watch JUST LIKE THE TEAM SERGEANT. :D LOL
Just kiddin with ya' Solid. You did answer your own question perfectly though. Good luck
Are you more interested in treatment for Chronic shin splints situations?
:D I'll definetly try the stretching. I only stretch out my calves before running, so I'll try it in the morning.
If you have anything to say about chronic shin splints, I'd be all ears. This is probably a problem I'll be facing in the long term.
Thank you,
Solid
Sacamuelas
05-11-2004, 09:27
I am sure that one of these guys like Cric has faced this very recently. My typing fingers are getting sore. LOL I will defer to someone else to answer.
If no one answers after a while, I will give you info on what always worked for me, and what I was always told.
In the above post, I answered only stretching because you listed it as a proven cure for you already. There are more prevention techniques out there as well as palliative Tx (like taping) that is recommended (although I must admit taping has NEVER really helped me personally).
I'm just glad to know that there ARE preventative measures available. Because over-pronation, even with good orthotics, is hard to fix, I figure I will be suffering this problem for quite a while.
Thanks again,
Solid
Kyobanim
05-11-2004, 09:35
Originally posted by Solid
but I never have time to stretch when running to catch the bus :)
Solid
What most people fail to realize is that you can do basic stretches while:
waiting for the coffee or tea to brew
drinking said beverage
fixing breakfast
eating breakfast
showering
in line at the store
sitting at your desk
riding the bus
etc.
You don't have to stand or sit and do rigerous stretching routines. Think about your daily routines and integrate basic stretches.
Just my .02
Surgicalcric
05-11-2004, 09:51
Solid:
To echo what has already been said you have answered your own question.
Here is an exercise/stretch that has helped me greatly. While you are sitting in class, at the table eating, watching TV typing here, etc... Curl your toes and foot upward and try to touch your big toe to your shin; You will feel the stretch in the front of your shin. Hold the stretch as long as possible and then relax and do the same with the other leg. You should do 3-4 sets of these everyday.
I have been using this stretch and it has totally taken care of my problem with shin splits.
You also need to be sure you stretch the Soleus...
http://www.rice.edu/~jenky/images/soleus.gif
...and the Gastrocnemius as well.
http://www.rice.edu/~jenky/images/gastroc.JPG
Alot of musculoskelatal problems induced by training and non-trauma related, can be resolved or better yet prevented with a good, THOROUGH, stretching routine.
HTH.
Perfect. Thank you for your help, guys. The 'big toe' stretch seems to be the most effective, I already do the other ones.
Thanks again!
Solid
DoctorDoom
05-11-2004, 14:52
x
DD,
I get them whenever I run suddenly (without serious stretching) or sometimes even when I walk. They'll last for either an hour or, if I had to strain repeatedly (run twice to the bus), the entire day.
The symptoms match those listed by webmd for medial shin splints, and my feet are flat as the floor.
Do you think that it's something else? My diagnosis could obviously be faulty.
Thank you,
Solid
NousDefionsDoc
05-30-2004, 10:41
You can also take a glass coke bottle or piece of pipe and roll it gently back and forth of the affected area. Gently is the key word here.
I'll certainly give it a try. Thanks, Doc.
Apparently, medial shin splints are caused by scar matter forming but not going away, which presses on the nerves. The best way to deal with them, if this is true, is to massage the effected areas hard so as to dislodge the scar tissue.
This is all according to the dude that owns my local running store, so it could be total BS. However, it seems to be working. I ice my shins after long runs, too.
Now where's that dang bottle of Sol?
Solid
DoctorDoom
06-03-2004, 05:32
x
I only get them after runs, both short and long. I've tried stretching before and after vs. just stretching afterwards, and the stretching doesn't seem to have much of an effect. I don't get the splints from walking long distances when rucking. I've been trying 'toe stretches' as Cric described, for a few months now (I think...) and it doesn't seem to have any definite effect.
Hope that helps,
Solid
DoctorDoom
06-03-2004, 16:19
x
If you are having these types of problems have you considered seeing a sports physiologist? Not an orthopedist but someone who specializes in lower extremety performance especialy running.
You probably wont find one in a small town if thats where you live, but its well worth trying to find a good one somewhere. He or she can look at your stride, symmetry, feet etc and give you recommendations. Considering it will only cost about $100.00 and that there is so much to loose from being injured...
Its sounds like you might have already tried this so pardon me if you have.
Possibly you are over training (for your body) and or consistantly running on too hard of surfaces. I believe sprint training should be done in intervals to regualr distance running and on sufaces such as grass if possible. Sprinting after a bus is simply asking for it IMO.
Aside from using the proper shoes for the type of feet you have, remember to purchase high quality running socks ie Thorlo.
If any of this is presumtive pardom me-
ccrn
Not presumptive at all. I'm in the middle of exams, so going to see a physiologist hasn't really been a possibility (my exams regularly stretch past the time most places close up). I will, however, get an appointment when I'm done.
Increasingly I'm thinking it might have something to do with the overall strength of my leg muscles. I used to be GTG because I skied and played Rugby, but it seems that they have deteriorated a fair amount. Would this be a reason for shin splints?
My sneakers are screwed after a month of training. This might also be the source.
My biggest problem here is that there are too many variables! Normally I can isolate and fix the problem, here I have trouble figuring out the causal relationship. Ah well, I can suck it up like I've been doing thus far. Thanks for the help.
Solid
Does your training consist of primarily running that aggrevates your shins, or are there other activities as well?
You mentioned earlier that you experience this while sprinting specificly sprinting in persuit of the bus. Rest is the best therapy for splints and pain that I am aware of.
Is it necessary for you to do as much sprint training as you are currently doing or can you decrease it? Unless your two mile times are poor perhaps its not needed.
Also it could be that you never started correclty and needed more time to prepare for aggresive training. If you have time you might want to take a month off from running and start over using one of the beginning 10k regimines-
ccrn
I'm 'taking a break' right now, more because of exams than anything else. I still have to sprint for the bus, though. With the exception of sprinting for the bus or to school if I'm late, I generally run 20 miles a weekend, although it varies based on how much time I have available and what the weather is like. I've been running shorter distances up until now, getting progressively larger. Shin splints really only resulted from sprinting, but sometimes they appeared after a run.
HTH,
Solid
May I ask what your end goal is?
If it is lifestyle fitness pehaps you should turn the running down a notch or two, and compliment your cardio workout with biking etc if you arent already.
If however your goal is a cetain level of ability by a specific target date you will need to modify your workout to prevent injury. I firmly believe many potential careers in the military, SOF, or LE end on a street or gym somewhere in the potential cadidates locale before they ever start due to improper training.
Then again, maybe that too is part of the selection process-
ccrn
It's a mixture of the two. Primarily I want to be fit for ROTC and then SFAS, but clearly the training necessitated keeps me in above average condition.
Is 20 miles too much? I can run 10 happily, so when I had been doing that for several weeks without injury or undue stress, I had a long weekend and tried running 10 one day, rest, then 10 again the day after. That was also okay, so I did 10-10 and it wasn't as easy, but wasn't impossible, either.
I saw that as a gradual enough transition to prevent injury, but of course I have no qualification to make that judgement.
I've started to ruck more often now than run, largely because of the shin splints, so they should calm down eventually. Is it possible that the undue stresses from the 10 mile runs did manifest themselves in the running, but instead in the short sprints?
Thank you,
Solid
I think youre running too much. Running back to back 10 milers on a weekend isnt healthy for your legs in my opinion.
Many lifestyle runners will go out every day but I recommend 3-4 times a week with a day of rest in between and ruck 2-3 times a week with no more than 55 lbs. Try running /marching on only soft surfaces. This may take some effort but remember you are only as good as your feet/legs if you are planning a highspeed career, invest in them wisely as they are two of your most valuable assets.
See www.jeffgalloway.com (Running Free with Jeff Galloway) and see if he has anything to offer you. Also look at www.runnersworld.com. Look at some running schedules and then tailor one to suite you and your needs. Notice that they are all staggered in mileage. You might try using a log. Some people like this and it can be useful in identifying activities that lead to injury.
Unless you are training for a marathon it isnt necessary to run so many miles. 5k (3.1 mile) training is more than sufficient for the 2 mile APFT and 10k (6.2 mile) will take care of just about anything else you will come across. You can run longer distances and stay healthy but its not necessary unless you are planning a marathon or mini-marathon. There are training books to do this.
I hope this in some way helps-
ccrn out
I figured that I'd need to do ridiculous amounts of running for SF, so I wanted to be in marathon condition. If that's not necessary, I'll scale back my activities to 7 milers.
Thank you for the advice,
Solid
I'm not BTDT but from what distances Ive been told to expect the above mileage will prepare you. A good measure is the 5 week SF prep:
http://www.usarec.army.mil/hq/sfas/prepare.html
ccrn
Can a BTDT verify this before I change my regime? Not necessarily in regards to SFAS, but in comparison to your own regimes or something similar.
No disrespect intended ccrn, I just want to double check. Your guidance has been valuable.
Thanks,
Solid
I am an infantry squad leader with 10 years of service. I know alot about shin splints. Here goes. Shin splints is a broad term that people use to define all sorts of pain in the lower legs. Especially the delayed muscle soreness that occurrs along the front of the leg, usually due to muscle weakness.
You can strenghten this muscle by running backwards, partner assisted exercises, standing pigeon toed and rising to your tip toes and then returning to the start position.
Also in some cases the tibia actually develops a fracture in which case you are out and just have to let it heal up. You can tell if you've got a fracture by an MRI or a bone scan. Both of which are very expensive, and not usually the first thing a doctor has you do. Usually they prescribe rest, ice, elevation, etc.
A podiatrist will check your gait, check which of your legs is longer (most people have one longer than the other), look at your feet to decide whether your feet are supinated or pronated, (high arches or fallen arches). Recommend a podiatrist for everybody, you could have one leg shorter, in which case they will give you some high quality orthotics.
If your feet are pronated they will usually have some orthotics made. And also prescribe rest, ice, elevation.
If pain still persists, its time to see an orthopaedic surgeon. You could have Medial Tibial Stress Syndrome - MTSS - true shin splints.
This can be helped by an operation, a fasciotomy. One leg is operated on at a time, usually there are two surgeries one for each leg, conducted six weeks apart, but, if you are a true wacko, and your doc is malleable, you might be able to convince him to do both legs at once, this will shorten the total recovery time by 6 weeks. NOT RECOMMENDED. Anyhow... now onto the surgery...
An incision is made along the inside of the lower leg. The nerve running along the inside of your lower leg and down into your arch through your ankle is isolated and set aside to avoid injury, the afflicted muscle is identified (there are three small ones in this area) , and its fascia is slit open. Then the surgeon will move the muscle aside and score the face of your bone, sort of fish scaling it, with a hand held steel tool, I think its called an osceoscope or something like that. It takes about an hour and a half under general anesthesia.
I ran for 10 years without ever having a single case of shin splints, then one day they just came on. I did all of the above. Just had my first surgery last week. My surgery would have had a better chance of success had I done it the first year I had this problem, back in 1996.
I am 34 years old, I made up my mind to become a special forces soldier while deployed last fall. Since my return, I began training like a mad man, and then, I just couldnt train at the level of intensity I needed to. So, I decided to take the bull by the horns, the pain was not going away with any amount of rest, ice, or stretching. I needed to get this worked on. It is the single greatest obstacle to my success, so I identified the root of the problem, the friction in my loop.
This surgery is done after all other conservative treatments listed above have failed. In my case - YEARS after first being afflicted with shin splints and being told to work out harder, to strech more, to run at different frequencies for different durations, to rest, to exercise more, etc.
I burn for the lifestyle that so many of you have. I cannot imagine ever walking away from it once I arrive. Every day, I think about how long a journey I have ahead of me. Like any great undertaking, this one will be built by small moments of consistant effort.
I think there are more Soldiers who suffer with this problem than one might think. But they suffer in silence, cause when you have these types of shin splints, it doesnt bother you to walk, or stand, only to run. And so others might think you are a malingerer, so you motrin up, and suck it up, and fall out of runs. STOP! See an orthopaedic surgeon, the younger you are the better the chances of success. There are not many studies into this problem. But I have one that was conducted in the UK.
The study follows several patients who had the condition and corrective surgery. The good news is that 80% of them had some rediction in the level of pain they felt. And only one of them had an increase in pain. I hope.
Anyhow, I live in Redding, CA. My doc is a retired Navy doc. And he's done his fair share of this operation before. I handed him my digital camera as I went into surgery, and he took photos. If any of you would like to see them, you can contact me at jose.a.garcia1@us.army.mil
The post surgery wasnt too bad at all. My wife picked me up and drove me home. I was somewhat naseous the rest of the day. The wound is about 8 inches long, intially covered with steri strips, gauze, and an ace bandage. I kept it iced and elevated for two days. Its been exactly one week since surgery, and I am able to stand and sort of limp around enough to do chores, go shopping, and go to the gym. I was prescribed vicodin, and motrin. I hardly took any vicodin at all, maybe 6 pills. The bottle is still sort of full. The motrin is for swelling. So I take that daily.
Around the ankle on inside of my leg its numb, and slightly swollen, the wound is numb still, but the numbness is fading, and the entire affair is sort of itchy now. I think that is good.
My advice to anyone suffering pain along the inside of their lower legs or outside of the lower leg, is to first see a podiatrist immediately, have them treat you for six months, if your are unable to run w/o pain, then see an orthopaedic surgeon.
Thank you for that information. I think (hope) that it was from over-exertion or maybe just a sprain of some kind. It only ever occurs in my right leg, which is slightly worrying because it hints at a deeper problem. I'm resuming my proper running this summer after as much rest as I can get for my leg.. I suppose that's when I'll know if it was a temporary problem or if things are going to get much worse.
I hope you recover quickly and everything works out,
Solid
Had my post op follow up this morning. Pre op, the doc had told me he was going to put a cast on it. But when I woke from surgery there was no cast.
So I asked him about that today. He told me that originally he had planned to fishscale the bone. But when he opened up my leg he could see that it was a muscular problem alone, and that the muscle was scarred, and had been injured.
So he conducted the fasciotomy, did some cauterization, (not sure why) 'tacked' the muscle back in place and sewed me up.
Its been about 10 days, and I no longer need a cane or crutches, he told me to start cycling and working out in the pool.
I am excited that the bone was not an issue, he says my chances for a full recovery are now about 85%. In six weeks I will have the right leg done.:D
Excellent news! Do you know what the injury was from, or if it was just scar tissue left over from muscle growth?
Thank you,
Solid
I cant imagine how I got all that scar tissue built up on the muscle, I was never down and out with a leg injury. I didnt think to ask my doc how I had acquired so much of it.
I suppose that subconsciously I assumed it was built up from years of running, and finally reached a level where it caused severe pain to run.
I hope its the same case with my right leg. If there is anything wrong with the bone, the recovery time has to increase. So in many ways I am lucky so far.
Swimming and riding bicycles are something that I have never felt a 'burn' from (when compard to running) , but as of now, they are the only two cardio exercises he has allowed me to do. :lifter So now I am chasing a runners high in the pool.
It seems (fingers crossed) that my shin pains have gone away. Unfortunately, I've been doing everything possible to help them disappear, so I don't know which technique was the most effective. I suppose the true test of my recovery will be this summer, when I start running again.
NG- If you see your doctor again, could you ask what the scar tissue was from?
Thanks,
Solid
Its been about 8 weeks since the surgery, the scab has completely dissappeared, I have no trouble walking or standing. Its pretty much pain free. I want to run on it, badly. But I wont because I really dont ever want to have that pain in my legs again, so I will wait the required time.
I got a letter from my doc last week. I am scheduled to have the next leg, my right leg, operated on the 11th. Looking forward to it. I have been ready to have it done for the last three weeks! Waiting so long only increases the amount of time I have to wait until I can start training again. Its not much fun not being able to do any running. Oh well, I have to pay my dues.
Great news! Good luck with the next leg. I'm interested in the recovery periods.. my left leg just started acting up, but I can still jog which is good.
Solid
Its roughly 8 weeks after the surgery, I will get the next leg operated on the 11th. I feel pretty good now. So, today I decided, (without input from my doc) to try and work out on the elliptical trainer. I was extremely pleased with the workout. Afraid to tell the doc though.
The Left leg, (the one that had the surgery) felt loose, it was a brand new feeling for me. The right leg, in contrast felt very tight in the afflicted area. I had no idea how stiff that area of my leg was because until the surgery I had nothing to contrast it with.
I expected the opposite to happen before I worked out. I thought I would have to baby the left leg. Instead it was the right leg that, from the start of my 30 minute work out until the end, remained tight, and somewhat stiff. After about 15 minutes the toes in my right foot were semi numb (this often happens to me on the elliptical trainer) the toes on my left foot were not numb and did not get numb the entire workout.
My words don't express the excitement I feel now. I am really happy with the results, I can't believe how tight and stiff my legs were. And to think my condition is only going to improve. My dreams of 12 minute two miles may yet come true after all.
Every time you post I feel more confident about my own legs (the left has now started acting up... frustration does not suffice to describe my feelings on it). How severe is the muscular decay (in estimate)?
Thank you and good luck with the right leg,
Solid
Solid,
Since you are there in the UK, this might be of interest to you.
The only published articled (and I think Peer reviewed as well) on Medial Tibial Stress Syndrome was written by some docs from the UK at Leicester General Hospital. Drs. Yates, Allen, Barnes(ben.yates@northampton.ac.uk)
The article is titled "Outcome of Surgical Treatment of Medial Tibial Stress Syndrome"
It appears in "The Journal of Bone and Joint Surgery" (jbjs.org), volume 85-a Number 10 October 2003.
There arent many studies on the subject, so this one is often referred to.
Thank you! While I am loathe to trust British doctors (many bad experiences of the highest degree), I'll still make sure to see if I can get my hands on it.
Thanks again,
Solid
Saw my Doc today for the pre operation appointment. I asked him what caused the scarring on the muscle. He told me that the scarring is from the stress syndrome, associated with overuse, it looks like "gristle" (sic?) and follows the same line as the muscle fibers. Scar tissue is not flexible, so it does not exapand when I use the muscles in my leg (run), the pressure in the muscle compartment simply builds up and gets worse as I run, causing severe pain, which only diminishes when the pressure inside the muscle (the fascia covers the muscle, sausage like skin) drops.
So the operation that was performed on the left leg and will also be performed on the right leg, is called a Fascial Release. The incision is made, nerve isolated, scar tissue removed, fascia is cut open, something is cauterized, closed up, and I am sent home.
I asked him about the revovery time. He told me that since the bone was not afflicted (as is common in this type of injury) my recovery time until I can start running again is 4 months. At two months I can use the elliptical trainer, at one month swimming.
The normal recovery time (for me) if the bone had been injured would have been about 9 months. So I am very lucky indeed.
Only 6 more days.
I just took the ace bandage off of my right leg that I had surgery on two days ago. The scar isnt in the same place as the scar on my left leg that I had surgery on in June for the same thing, Medial Tibial Stress Syndrom or shin splints.
The swelling isnt the same, the numbness isnt the same, and I am worried that the Doc didnt operate on the right spot on my leg. The spot he worked on I have never had pain in before.
Now let me try and figure out how to attach a photo to this post...
Not to worry, I'm sure there will be some sort of legal representation made available to you shortly now that you've chummed the water a bit:D
Well it appears I dont have the auth.. to post photos. Perhaps I can put them on a yahoo page. gimme some time. Any suggestions? I tried to post them here but each time I did it went to an all white screen that essentially said "check your network connections...etc"
LEStudent
01-04-2005, 04:25
Any update on your situation, NG? My shinsplints have been killing me for the better part of the past 5 years. I've done my best to ignore the pain, but I nearly had to drop out of the Academy due to the severity of my shinsplints. I've tried everything short of surgery to get them fixed, but they continue to get worse. My cat bumping into my leg feels like a ball bat hitting me.
There was no benefit from this surgery, at least in my case. Others have had some success, I havn't. For others with MTSS this is the best site I've found on the matter, and it has probably the best advice I've seen on the matter. I've read some rumors that cortisone injections in some cases worked for some people, and its something I want to try. If there are any docs in California willing to give it a go for me, give me a shout.
Anyway, here is the link to the best site I found, in my opinion, the article should be copied, and put on a sticky on this board. Its that good, but its a little long, again its absolutely the best article I've seen on Shin Splints - MTSS.
http://www.sportsinjurybulletin.com/archive/1079-shin-splints.htm
Quick question I recently had a bone scan and was told i have shin splints and stress fractures in both of my lower legs. My profile is a little contradicting and somewhat confusing it says i can not carry a combat load of 48 pounds for 2 miles. but i can do lower body weight training i understand the act of walking with a ruck is high impact. My question is can i strap a ruck on and do squats or is that putting to much pressure on my legs to allow them to heal and just concentrate on strengthening my core.
i apologize for posting in someone elses thread and the stress fracture thread was locked. I guess it might also be more of a training question which i also apologize for since i know you beat that subject to death.
The Reaper
04-16-2008, 05:14
I would ask the physician who wrote the profile.
He knows your case, we do not.
TR
Just to update. I am running again fairly regularly and pain free. I cannot say how much of my improvement is due to surgery, and how much of it is due to not running at all for a very long time (>18 mos.) and performing the exercises shown on the website I linked to.
All of the numbness is gone and pain is gone now, I can run as frequently as I did before I was first injured. YMMV.