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Shin Splints: A Common Running Injury
By:  Zoe Braul   (2007/06/22)


Running is great cross-training for cross-country skiing. But like any sport, running doesn’t come without the risk of injury. One of the most common running injuries is shin splints. I had pretty bad shin splints last year so I have some experience with this injury. I’m not a doctor or anything but this is what I have learned:

Shin splints is a term that generally describes pain in the front of the lower leg. It is mostly caused by inflammation of the periostium (sheath) that is covering the tibia (shin bone). It can also be caused by tight muscles in the calf and shin area that are pulling on the tibia.

What do shin splints feel like?

For me, it started out as a dull pain in the front of the lower leg. Also, when I pressed down firmly on the shin bone, it was really tender. As the injury got worse, it was so painful that even walking was difficult, especially up and down stairs. If you let the injury get bad enough, scar tissue can develop in the area. When I ran my thumb down my shin, it was bumpy. Apparently that was the scar tissue.

What can you do to prevent shin splints?

  1. Run on soft surfaces. Asphalt and concrete cause too much pounding and impact on the lower leg. Not only is running in the woods more enjoyable, but it’s healthier for the legs.
  1. Invest in proper footwear. Have your feet professionally assessed to find the best running shoe for you. If you are flat footed, extra support may be right for you. For some people, a good pair of well-fitting running shoes is all they need. But for others, a custom-made orthotic is necessary. Although orthotics are very expensive (mine were $450) they are worth it! Wear your orthotics in your runners, ski boots, hiking boots and even work shoes.
  1. Stretch. Focus on the shin and calf area. Keeping the surrounding muscles flexible prevents them from pulling on the tibia.
  1. Train smart. Yes, you may be eager to turn yourself into a marathon runner in one month, but that is a perfect way to injure yourself. A sudden increase in intensity or volume causes the muscles in the lower leg become tight and strained. Just because you kicked butt in the ski season, doesn’t mean you’re ready to do marathon distances in running.

If you think you have shin splints…

  1. See a doctor who specializes in athletes. Once they have determined that you do, in fact, have shin splints, they will probably refer you to some specialists. If they think the shin splints are bad enough, you may have to go in for an x-ray to determine if you have a stress fracture in the tibia. (This would be the worst case scenario. If you run through shin splints, your muscles can pull the tibia so hard that a hair-line fracture can develop. This would not be good, because recovery would take weeks. That sure puts a dent in your hard training!)
  1. Stop running! Or at least, cut your running down by more than half. Bottom line is that if you run with shin splints (no matter how slow) you are making the injury worse.

Training with shin splints

If you have been diagnosed with shin splints, there are a number of ways to stay in shape that don’t require running:

  1. Cycling is great for skiing. I hear the Gatineau Park is a heaven for avid cyclists, so take advantage of it!
  1. You’re probably already rollerskiing, but be sure that it doesn’t aggravate your shin. Rollerskiis are heavy, and lifting one with the front of your leg when you rollerski can strain the muscles around the tibia.
  1. You can also try water running! Sure it looks nerdy, but if you do it right, it’s great exercise. Your local pool should have flotation belts that buckle around your waist (think Aquafit classes for seniors). Strap one of them on and run in one spot in the water. (Note: your feet don’t actually touch the bottom of the pool. You are just going through the running motions. The best plan is to do it in the deep end of the pool).

So as the running season is well-underway, be careful to stay injury-free! The most important thing I learned is to listen to your body. If you have shin splints, don’t let anyone push you into running “through the pain” just because it has worked for them. Shin splints are one thing where “no pain, no gain” is definitely NOT true.

Happy running!!

NOTE from Andrew Wynd, Physiotherapist.

Shin splints is the common name to refer to any anterior shin pain and as Zoe has correctly identified, can be due to any number of causes. Whilst the most common cause for pain is periosteal irritation from muscle dysfunction, other causes and diagnoses are possible. These include compartment syndrome, tenosynovitis, tendonopathy and stress fractures. Due to the possibility of any number of these injuries being the cause of your pain, please see a sports medicine expert or physiotherapist to attain an accurate diagnosis.

More often than not, training errors (ie: too much, too soon) are the underlying cause for these issues. The lower limb is very good at adapting to stresses placed on it, but only when it as a chance to recover from the loads you place on it. Build up your running slowly as Zoe suggests, run on varying terrain or offroad if possible and keep your running shoes in good condition or change them every 6-10 months.

Aside from training errors, biomechanical factors often weigh into the problem and lead to excessive strain placed on soft tissue structures. A biomechanical assessment and possible correction via orthoses or a strengthening program is often required as part of an active treatment approach.

Follow Zoe’s good advice above and if any have any problems, go and see your sports physiotherapist.

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