Your Personal PT, Rachel Tavel, is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS) at Shift Wellness in NYC, so she knows how to get your body back on track when it’s out of line. In this weekly series, she gives you tips on how to feel better, get stronger, and train smarter.
Ever feel like you might have gone a little too hard, too fast? It happens to the best of us. You’re working out and feeling good so you begin ramping up your workout intensity or duration. Then, just when you were feeling good and strong, you begin to get a dull ache in the front of your shin. The pain comes and goes until it’s enough to bring you to a screeching halt.
Shin splints might be to blame. Shin splints, also known as medial tibial stress syndrome (MTSS), is a pain syndrome that usually occurs after repeatedly loading and stress to the lower leg. The condition can be due to ramping up a workout routine too quickly, or after repeatedly pounding hard pavement without the proper footwear, body mechanics or support.
Pain is usually felt at the front of the lower shin bone (or tibia), two-thirds down from the knee above the ankle. It tends to be worse after increased activity. Unfortunately, shin splints can be quite common in runners or anyone participating in sports that require running and jumping.
While it’s easy to blame yourself, other factors can contribute to the development of shin splints besides going a little too hard, too fast. Footwear and the type of ground surface you’re exercising on can be partially to blame. Ask yourself: Are my sneakers more than six months old? Am I spending too much time running or jumping on concrete? Or maybe that new, trendy pair of kicks just isn’t working for you. Form, strength, training regimen, and body mechanics play the largest role in the development of shin splints—but these outside factors affecting shock absorbance and ground contact are the most easily altered if you want to make some quick changes.
While shin splints can feel like someone is taking a hammer to the front of your lower leg, it’s not perfectly understood what exactly is causing the pain. Commonly, the that pain is attributed to chronic inflammation of the tibialis anterior muscle causing possible microtears along its attachment point to the tibia. This can be due to weakness in this muscle or overuse due to weakness elsewhere and poor running mechanics. Tightness in the posterior calf musculature may also limit use of this muscle, leading to straining of the tissue.
If shin splints is not addressed early on, you run the risk of developing a stress fracture. So don’t grin and bear it—see a physical therapist and get treatment before you do more serious damage. In the meantime, try to take these steps.
Adjust: Begin by reducing your exercise frequency and intensity and continue changing footwear. If even these changes don’t help, stop the aggravating activity and consider resting or replacing your workout with a low impact cardio workout such as swimming or cycling.
Stretch: Stretch the gastrocnemius, soleus, and other muscles of the lower extremity and hip to help reduce the load on the injured tissue and allow for optimal mobility at the ankle, knee and hip. Try a heel off the edge of a step calf stretch with the knee straight and the knee bent, holding each for at least 30 seconds. Make sure you address the hamstrings, quadriceps, and glutes with proper stretching as well.
Foam roll: Try foam rolling the calf musculature to start, but you’re also going to want to get into the tibialis anterior. To foam roll the tibialis anterior, try bending the knees so that your shins rest over the foam roller. Gently move up and down over the length of the muscles, supporting yourself with your hands to offset the pressure and weight.
Strengthen: Begin by strengthening the calf muscles. To do this, try eccentric heel raises: Stand at a countertop or rail and go up on both toes, then remove one foot so you’re standing on only the injured side and slowly lower yourself down with the one leg (go up on two, down on one). Repeat this for 2 to 3 sets of 10. While pain is felt along the shin bone, you may want to focus your strengthening on the hip muscles, namely the gluteus medius and maximus. Resisted hip abduction, clamshells, lateral walking with a band around the ankles are all good ways preliminary exercises.
Balance: Balance exercise, or proprioception training, can help your body learn to stabilize on an uneven surface or with external perturbation to your system. Try balancing one on leg on the floor, then progress to balancing on a squishy surface (a BOSU, Dyna Disc, or foam pad work). Once that’s easy, try balancing on an uneven surface while passing a dumbbell around your body in circles, moving the opposite leg or throwing and catching a ball in the air.
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