- Exercise & Fitness
Effective Shin Splints Rehabilitation
Treating Shin Splints
Shin splints is an overuse injury commonly affecting runners and joggers, and the full range of sportsmen and women. It can be highly painful, so much so that exercise is all but impossible, a constant pain which can be endured but is a constant frustration, or an intermittent problem experienced during or after exercise. It is characterized by pain in the shins, with swelling of the shins at the site of the injury often present.
Treating shin splints is similar to treating other muscle and tendon problems caused by overuse, and the classic treatment of RICE is the best initial treatment. It is highly effective when used for the first 72 hours after the injury has been sustained, and will minimize damage and pain. RICE stands for Rest, Ice, Compression and Elevation, and it is a standard treatment protocol for muscle injuries such as shin splints.
RICE Therapy for Shin Splints
Rest will give the body time to heel and will prevent further damage from hampering the healing process. Ice applied for 15 minutes twice a day will reduce inflammation, and it also acts as a painkiller and will reduce swelling. Heat at this stage is likely to increase inflammation and swelling, and whilst hot/cold treatment may be beneficial later on in the shin splints rehab process, initially it could make the pain worse.
If this treatment regime is applied at the first sign of shin splints symptoms, the chances are that you will only be sidelined for a couple of weeks, or even just a few days. If the condition deteriorates it can take a couple of months or even a much longer rehabilitation phase to get back to full fitness and strength.
Unfortunately for anyone who needs to get their exercise fix on a daily basis, or for those in training, the temptation is to carry on with exercise and try to run the pain off. Whilst the pain can abate, without appropriate treatment the condition is likely to return with a vengeance.
Supporting the shins and feet during activity is a great treatment and prevention measure, with compression beneficial for limiting damage, improving blood flow and preventing excess fluid build up. Elevating the leg will also help to achieve this. RICE therapy is most effective if applied at the first signs of shin splints symptoms.
Shin splints is certainly bad news, but in most cases it is easy to treat, and if a comprehensive shin splints rehabilitation regime is followed, a full recovery can be made in the quickest time frame. After one bout of shin splints, it makes the problem far more likely to come back, so support for the shins, proper footwear and other preventative measures should be taken to avoid a recurrence.
If you are experiencing pain in the front of your shins, rest your legs as much as is practical, and avoid high impact exercises. In order to stay active while you give your shins the necessary rest, try cross training with low-impact activities like swimming, bicycling or even upper body strength training. High impact exercises are one of the main shin splints causes.
Footwear, Arch Support, and Simple Compression
The feet act as shock absorbers, taking the impact from each step and spreading it out more evenly. When the feet are tired or the arches have collapsed, the foot can no longer absorb all of the shocks from walking and exercising.
Sufferers of shin splints who also have low or high arches should get improved support. Whilst the foot arch is some distance from the shins, there is a knock on effect when the muscles and shock absorbing apparatus in the feet become fatigued. Shock absorbing ability is reduced when the feet are tired, and the bones and muscles in the legs have to cope with a greater strain.
Wearing the right shoes for your feet and running style can be the single most important decision you can make in preventing the recurrence of shin splints. Specialist running shoes may be more expensive, but can prevent expenditure on treatment for fatigue injuries and will give your feet the support that they need, which in turn will let your shins have an easier ride.
Shoes wear out frequently, around every 500 miles or so, and can become less effective over time with the shock absorption and support degrading with use. Replace your running or exercise shoes every 500-800 miles, or sooner if you notice that they are getting worn.
Shin splints compression socks and supports can be effective for some, although not everyone claims that they are effective. However, if you want to carry on exercising whilst you recover from shin splints they can be highly beneficial and can prevent further damage. Kinesio taping has been attracting a lot of attention in recent years as both a treatment and a prevention method for shin splints, but more about that later.
Kinesio Taping to Support the Shins
Shin Splints Rehab Exercises
Stretching exercise are a vital aspect of the shin splints rehabilitation process, and are important for keeping the tendons stretched, loosened up and ready for action. Warming up the muscles and tendons before exercise is vital to ensure that they are ready to cope when you put them through the paces. Without a warm up, muscles are far more likely to get injured, sometimes even severely. Whilst every runner and jogger will be aware of that, the shins often get ignored in a warm up.
Whilst most runners and joggers will complete a hamstring stretch, groin stretch, and get the calves and buttocks stretched out, many ignore the shins. As such, whilst other muscles may be ready for a run, the anterior and posterior tibialis tendons in the shins may not be.
Similarly, after exercise, the same stretches should be performed to give the tendons and muscles a gentle warm down to keep them loose and limber. These exercises should form part of a daily stretching routine too, but are especially important before an after exercise as a preventative measure to avoid shin splints.
Stretching the Anterior Tibialis Tendon
The best stretch is to kneel down, and sit upright with the buttocks resting on the heels, and the top of the feet flat against the floor. Hold this for around 30 seconds until you start to feel the stretch in your shins. Stretch out and repeat as necessary.
Stretching the Posterior Tibialis Tendon
Standing up straight using a wall for balance, raise the heels and transfer the body weight to the toes, and lift up as if you are in high heels. The body weight should be on the smaller toes. Hold for 10 seconds, lower and repeat as necessary.You should feel this exercise stretch both the calves and the posterior tibial tendon on the outside of the shin.
Strengthening the Tibial Tendons
Arguably the most important preventative measure, and a vital aspect of shin splints rehabilitation process is to perform strengthening exercises. Strengthening the tibial tendons can be highly beneficial, especially considering the recurrence of the complaint after one episode is greatly increased. If the shin muscles are weak, they will be prone to injury and strengthening the muscles and building up stamina will make them better able to cope with exercise.
Using resistance training to strengthen the shins can be invaluable, and will bring the strength and stamina in line with the rest of the body. There are many ways to do this, but one good option is to place a big book under the heel, and strap a light weight to the forefoot. Simply flex the foot up and down. Repeat so you can feel the effort in your shins, and increase gradually the duration gradually.
Kinesio Tape for Shin Splints
When applied properly, kinesio tape can be highly useful tool in the fight back to fitness as part of a shin splints rehabilitation program. It also is a great preventative step to take to avoid the condition in the first place.
When applied properly, these "go-faster" stripes really does look rather splendid, ad can actually increase performance. By guiding the muscles through the perfect motion, they can actually improve their performance. They are also perfect if you want to cure your shin splints whilst pretending to be Tron.
The application can be simple (above), or more complicated (right) depending on the time you have available to apply the tape, and naturally the nature of the injury. Kinesio tape can be bought online, although it is best to at least initially visit a Certified Kinesio Taping Instructor. CKTI Accredited instructors have been trained in the correct application of the tape. Whilst once the secret of physiotherapists, it is now being used by more and more doctors for the treatment of sports injuries.
Kinesio tape is not a new treatment , and has been around for around 25 years. Recently however there has been a surge in its popularity for general use, now that there are more trained kinesiologists (for wont of a bitter word), and no doubt helped by the publicity that David Beckhams legs, Serena Williams body and Lance Armstrongs thighs bring.
Olympic teams are now using the tape during training to promote proper muscle use, as well as for treating niggling injuries and more serious conditions.
How does Kinesio Tape Work?
The tape works by assisting the muscles and guiding them through the correct, or desired movement. When applied in one direction the tape will help guide the muscles through the correct motion, and lifts the skin away to give them a little more room to move. This is said to help prevent injuries and can even improve the performance of the muscles.
When applied in the opposite direction Kinesio tape will inhibit muscle compartments to help speed up recovery from injury. It can be applied directly to the leg, is unnoticeable when worn, and can be worn for up to 5 days at a time for constant treatment, giving it a significant advantage over other forms of strapping.
Compression Socks and Supports
Part three of RICE therapy is compression, and it is beneficial with shin splints for reducing swelling and offering some support to the tibialis tendons in the shins.
There are many ways to create compression,from simple bandaging to compression socks and supports. The idea is that by keeping the muscles compressed, you can prevent injury by reducing the stress placed on the tendons. The socks can improve blood circulation and control excess fluid to limit swelling. Some disagree on their usefulness, but there have been many claims that they have proved to be beneficial in treating and preventing shin splints, and are a valuavble part of any shin splints rehab program.
A recent study* suggests that the socks can delay or prevent delayed onset muscle soreness, with only 2/13 compression sock wearers experiencing symptoms, compared to 13/14 without the socks.
Some swear by it, some swear it's a waste of time and money. It is interesting that those that believe it will work have a far higher success rate. For some, acupuncture can be a valuable part of the shin splints rehab process, especially when used as part of a comprehensive shin splints rehabilitation regimen.
Acupuncture has been used for thousands of years for the treatment of all of mankind's ills. Acupuncture is believed to work by tapping into the body's CHI, or its life force, which flows through the body in channels, or meridians. Small manipulations in strategic acupuncture points around the body can restore the flow of CHI, help the body get back into balance, and allow the body to heal itself naturally.
Acupuncture for shin splints can involve different techniques, although almost certainly needles would be used not just at the site of the problem, but along the meridians in other parts of the body. When accompanied by a host of other shin splints rehab techniques, it can make a difference with some sufferers.
Doctors may not be able to agree on the science behind it, but acupuncture for shin splints has shown results. If you want to give it a try, look for a qualified practitioner, such as one having the accreditation ACAOM or a similar recognized body. Always choose a practitioner who uses sterilized single use needles.
Choose the Right Shin Splints Rehab Program
There are many options for shin splints rehab, and the best combination of treatments will vary from individual to individual.
If shin splints is mild, simple exercises, stretching and an upgrade in your footwear may be all that is required. For persistent problems and severe shin splints, it is worth seeking medical advice and considering a broader range of treatments in addition to stretching and strengthening.
*Ali, A., M.P. Caine, B.G. Snow. 2007. Graduated Compression Stockings: Physiological and Perceptual Responses During and After Exercise. J Sports Sci 25(4): 413-419