My Shin Splints Brain Dump and Cure

I struggled with chronic shin splints for at least a dozen years before finally getting them under control around three years ago. Here is everything I know about shin splints, and what I did to fix (or at least suppress) mine...

(Usual disclaimers apply: I'm not a doctor, trainer, etc. Follow at your own risk. This is just what I've read (probably with poor comprehension) and what I've done for my own shin splints.)

Definition

"Shin splints" is a garbage term that pretty much covers any form of recurring shin pain. Such pain can be caused by any of the following:

  • Overuse or overpronation can cause tendinitis in your shins.
  • Repeated jarring (like from running :-) can cause the lower-leg bone sheath (periosteum) to become inflamed.
  • Nerve irritation can develop from friction with the surrounding muscles.
  • Stress fractures, although in my experience you get the other problems first, and then this develops, laying you up for awhile.
  • Finally, compartment syndrome. Very bad. All the stuff in your leg (muscles, veins, nerves, etc.) run through four different compartments, each wrapped in a sheath. If the stuff swells and is constricted by it's compartment, your blood flow can get cut off (and I hear it hurts like hell). Relatively rare, but very serious. Seek medical attention immediately. Now. Yes, you can lose your foot if the circulation is cut off for too long. Cold or blue feet are two giveaways, although I don't know if they will always happen.

Prevention

Obviously, the best thing to do is figure out the cause of your shin splints and eliminate it. Here are some ideas:

  • See a good orthopedist who works with athletes (he/she should watch you run, not just look at how you stand) to determine the cause or your shin pain. If you overpronate, you'll want to wear proper shoes, and possibly have said orthopedist make you custom orthodics. I've never actually performed this step personally, but probably should, even though I now have a system that keeps my shin pain in check (more on that shortly).
  • Increase your running distance and/or speedwork gradually. Your body has to grow tolerant of the impact.
  • Run on softer surfaces (although I believe this can possibly be counterproductive for shin splints caused by overpronation rather than impact stress, as it introduces even greater undesirable motion in your foot).
  • Lose weight, if you're carrying extra baggage. Every pound you lose reduces impact stress on your shins.
  • Do stretching and strengthening exercises for the front of your lower legs. Running strengthens your calves out of proportion with your shins, so you want to try to keep them balanced. I actually don't have a source for this, so might very well be making it up. Pretty sure I heard that somewhere though.
  • Ice after workouts. Even if you're not in pain, ice will help prevent inflammation.

Treatment

If you're already in pain, here are things you can try to get relief:

  • Rest until you aren't in pain any more, and then build up more slowly.
  • Ice.
  • Ibuprofin or some other anti-inflammatory.
  • Some folks try wraps or tape, but these have never worked for me. In fact, for me the compression sleeves you can buy made them worse. Your mileage may vary.
  • ...and pretty much everything under "Prevention" above.

Many of you will want to play through your shin splints. I know I have. In the dozen or so seasons I strugged with shin splints, I probably successfully played through them twice. The other 10 times they kept getting worse and worse until they were unplayable. Based on those stats (and conventional wisdom), I don't recommend playing through them. Notice, though, that I tried to play through them all 12 seasons, and did so mostly by consuming far more Ibuprofin than I should have. I'm not the sharpest stick in the eye. So do as I say, not as I do.

My Shin Splints Experience

My struggles with shin splints began in college, playing Ultimate Frisbee on a field that was so hard it may as well have been a parking lot. Even though I was in good shape at the time, the pounding was just too much for me. Ibuprofin and stupidity got me through all my college seasons. After college I continued to be dogged by shin splints. Notice I keep using the garbage term as I never really had them properly diagnosed, although I do know that I overpronate. As I settled into adulthood and declining fitness, my yearly cycle would look something like this:

  1. Basically take the winter off from exercising.
  2. Start playing Ultimate two or three times a week around April. Lament the dismal state of my fitness, but enjoy pain-free shins.
  3. June. Fitness improves. Shin pain begins. Start Ibuprofin diet.
  4. Around July. My pain/performance peak.
  5. August through the end of the season. Watch my pain curve increase, and beat down my performance curve.
  6. Rinse. Repeat.

Then, finally, around three years ago I tried playing a couple games of indoor Ultimate over the winter. Within two sessions I started experiencing June-level shin pain. I knew something had to change. And besides, as I mentioned elsewhere, I was tired of sucking. So it was time to get in shape and fix my shins once and for all. Here's what I did:

  1. Hopped on the NordicTrack. I've written elsewhere what a great machine this is, but for my purposes in particular is was perfect. I needed to get some exercise outside the high-impact context of Ultimate, I needed to lose some weight, and I needed to work out my lower legs. Even jogging brought on shin pain for me, so easing into running slowly wasn't an option. The NordicTrack was a good, full-body, aerobic workout, and the balance component of the exercise really worked my lower legs well. In fact, for my first several weeks of my workouts on that machine, most of my soreness (the good kind) was in my lower legs and shins.
  2. Lost 20 pounds. Then another 20 pounds. The first 20 was enough to make a big difference for my shins though.
  3. Started icing religiously after each and every workout that had any kind of an impact component (jogging, running, rope jumping, competing, etc.). Note that this means I am icing healthy shins! I am not waiting for the pain to start. For icing anything, but especially shins, I can't recommend Cryopak Flexible Ice Blankets highly enough. They are cheap, five or six fit nicely in a small personal cooler, and you can wrap your entire lower leg with one or two (depending on what size you buy and how tall you are). Man, it gets you good and cold. I just put them right on my skin and wrap them down with a snug Ace bandage. I'm not recommending direct ice-to-skin contact in case you get frostbite or nerve damage or something, but I've never had any problem with it personally.

That's it. Less weight, better fitness, and regular ice. I'm not sure which of those factors had the biggest influence, but I've been shin splintless for three years now, and I thought I was always going to be stuck with those bastards.

I still overpronate though, and I just learned that might account for my high number of ankle sprains, random foot pain the day after Ultimate, and inclination towards calf cramps. I really should do the right thing and get that checked out. And so should you, if you're anything like me.