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Shin Splints: Learn To Run Pain Free!

A common injury associated with figure or endurance training is a shin splint. To help improve this sometimes debilitating injury I have put together a list of suggestions and shoe types to ease your pain.

By: Dr. David Ryan

One of the most common injuries associated with figure or endurance training is shin splints. The pain will stop your cardio program in its tracks. Even one simple step produces a feeling of broken glass rubbing in your shins. Shin splints are simple to diagnose and even more simple to treat.

The most common cause of shin splints is a weakening and a drop in your foot's arch. Once the foot arch drops, the shin muscle, called the Tibalis Anterior and its tendon will stretch and tear. This results in the loss of normal blood supply and the tendon will start to inflame and after a couple of weeks, results in painful degeneration. That is all it takes and you will have significant sharp bites in the front of your shin when you walk or run.


Testing

A Simple Test

    I do a simple test to determine if a weak arch is the cause of your shin splints.

    Ask: Does it hurt more with or without shoes?

    If The Answer Is: More pain without shoes, then you are likely a candidate.

Step On It

    As a physician I am used to touching patients, so this test is easier for me and remember, you are likely to have a false negative if you perform it improperly.

    1. Have the athlete stand on their feet.


      Click To Enlarge.

    2. Locate the area of pain on the front of the shin.


      Click To Enlarge.

    3. Position yourself to allow you to maintain an even finger-tip pressure on the front of their shin and still have an ability to reach under that same foot. I have found this is best if I have a patient stand on a rigid hard surface, like a strong table.


      Click To Enlarge.

    4. While you find the area of pain, continue the pressure. With your other hand, apply about 10 pounds of force into the arch of the foot, from the sole of the foot, press and hold up, about an inch or so in from the edge of the foot and mid arch.


      Click To Enlarge.

    5. When you apply the pressure on the sole foot up, note if the shin pain is less. Confirm this by releasing the pressure on the sole of the foot. If this release of pressure results in additional pain returning to the shin, then you are likely to have shin splints that can be easily corrected.

      View Video Of Step On It Test
      MPEG (1.4 MB)
      Windows Media (55 KB)


Ruling Out The Uglys

If you do the previous test and get no relief from the pressure you could still have simple shin splints; however, it is likely that you will need more than the limits of this article will provide.

If the pain gets worse when you press on the bottom of the foot, the athlete could also have a condition known as Plantar Fasciitis. You can seek the opinions of a podiatrist or an orthopedic surgeon, who specializes in foot and ankle (very rare). In any case they should be able to suggest a conservative mode of treatment that could eventually lead to surgery if your pain continues.

Step One: Get The Right Shoe

    It sounds simple, but getting the right shoe is about as difficult as finding the right person to be your mate for life. Various shoe categories exist, since everyone's feet and gait are different.

    A company called FLEET FEET has shown to be the cutting edge in proper foot fitting. This store offers a foot measurement both sitting and standing, then a video tape analysis of your feet as you walk on a treadmill.

    This helps provide you with the proper type of shoe. Most shoes if you are running about 30 miles a week, will last you about two months, however, there are some ways to stretch that time.

Step Two: Orthotics

    Orthotics fit inside of your shoe to provide a platform for your foot to rest in, while in the shoe. Ha, you say, "My shoes have an arch support!" Most manufacturers (99.9%) spend a whole 50 cents on their insoles.

    Another company called SUPER SOLES has produced a patented cheap shoe insert that runs about $35 and will last over two years in most cases. I can only speak from experience, that putting these inserts into the right pair of shoes, has made me very popular with the ladies.

    Okay, okay, maybe just those with shin splints, but it's nice to be appreciated!


Additional Suggestions

  • Take a towel and sit on a chair with your feet on a smooth surface. Place the towel on the ground and use your toes to grip the towel and practice lifting it up. Repeat about 100 times. This will help develop the supportive muscles in the bottom of your foot and the front of your shin.


Towel Lift.
Click To Enlarge.

View Video Of Towel Lift Test
MPEG (1.7 MB)
Windows Media (64 KB)

    After performing this function, move to the stairs and place your heel on the stair, then allow your foot to point down, while maintaining pressure on your heel. This will allow your shins to stretch. Hold for 30 seconds and repeat 5 times.


    Shin Stretch.
    Click To Enlarge.

  • Try switching up your cardio. Make a cardio program that allows you to use lower impact equipment. An example is 5 minutes of recumbent bike, 5 minutes of stair climber and 10 minutes of elliptical.

  • Do not use NSAID's after two weeks, it just complicates the problem of healing.

    What Is A NSAID?
    A nonsteroidal anti-inflammatory drug, such as aspirin or ibuprofen.

  • Use topical pain killers like Icy Hot, Medic Ice, Bio Freeze on the shins prior to exercise.

  • Use ultrasound, cold laser or electrical stimulation to assist in healing.

  • See a physician for help, if you don't get better in a couple of weeks, find a new physician.

  • Eat lots of sulfur content foods, Onion, Garlic, etc.

  • Take some advice from a guy who is serious about his shoes. My professional soccer career was ended, due to a bad pair of shoes. You need this piece of equipment to work properly while you run, or you will be sitting on the bench. If you must know, I wear the Brooks Beast. If you weigh more than 200 pounds then that should be your shoe too.


Optional Information On Shoes

Shoe Types

    There are three groups of running shoes; cushioned, stability and motion control.

    1. Cushioned: Obviously provides maximal shock absorption, not much support.

    2. Stability: Very strong mid-sole material, best choice if you weigh more than 200 pounds for a male or 150 for female.

    3. Motion Control: Very firm shoe, best if you have wider feet or flat feet.

Quick Terms:

  • The out-sole: This part of the shoe touches the ground. The heavier you are, the flatter the shoe should be. The black soles that are made of carbon rubber last the longest.


    The Out-Sole.
    Click To Enlarge.

  • The mid-sole: This is what you want to pay attention to if you weigh more than 200/150 pounds. Several materials are used here (see table 1)


    The Mid-Sole.
    Click To Enlarge.

  • The Upper: Also known by real runners as the "sales hype." This is the part of the shoe that covers the foot. It should breathe and provide support. Most of all, the shoe's "upper" should fit the foot correctly. There should be one-thumbs-width from the end of the big toe to the front of the shoe.

    Lastly, to prevent blisters, it should be padded to prevent rubbing.


    The Upper.
    Click To Enlarge.

  • The Heel Counter: This is a rigid cup that is built into the shoe to prevent heel movement. Cheap shoes don't include a heel counter.


    The Heel Counter.
    Click To Enlarge.

  • Post or footbridge (Arch support): This provides stability to the shoe while the foot moves from the heel strike position to the toe-drive-off position.

Table 1
Midsole Materials Common Uses
Ethylene Vinyl Acetate (EVA) Stability
Polyurethane (PU - it does stink too) Cushioning
Combination of EVA and PU Motion Control
Air/Gel/high-tech plastics Stability/Cushioning/Motion Control


Injury Prevention Via Education

Pronation

    A pronated foot rolls inward at the ankle, the mid-foot bulges inward and the longitudinal arch flattens. Excessive pronation is the most common cause of running injury. Those who over-pronate generally have flexible and unstable feet, so they need running shoes with a lot of motion control.

    A motion control shoe has design features that give a high level of support - a firmer anti-pronation post on the inside of the mid-sole; a firm or dual density mid-sole; and a firm heel counter. Excessive pronation is commonly associated with flat feet.

    Quick Tip For Pronators:
    Lye a towel on the floor, place your foot on the bottom of the towel. Using your toes, pull the towel into a ball, then straighten it out with your toes again.

Supination

    A supinated foot rolls outward at the ankle and has a high arch. They tend to be more rigid and are poor at absorbing shock, so they will need running shoes with a lot of cushioning. Cushioned shoes tend to be poor at motion control, commonly associated with high arches.


    Pronated, Nuetral & Supinated Feet.
    Click To Enlarge.

    One of the best ways to help determine what kind of foot you have is to perform a simple "wet test."

The Wet Test

    This test is simple, next time you step out of the shower, step onto a piece of clean copy paper. Out line the mark that your foot makes on the paper. Take it with you to the shoe store.


Dr. Ryan's Shoe Recommendations
For Those Who Weigh Over 200 lbs Or Wear Over A Size 13 Or EE Width.

  • Mizuno Wave Legend
  • Adidas Calibrate
  • Brooks Beast 7 (Dr. Ryan's Favorite)
  • New Balance 1122
  • New Balance 1220
  • Nike Air Structure Triax
  • Saucony Grid Stabhli
  • Asics Gel MC
  • Asics Gel Kayano
  • Asics Gel Koji GS

    Most shoes that have lots of gray in their mid-sole will last longer then the all-white ones.


Key Points About Shoes

  • Most shoes don't last longer than 1,000 km.

  • To tell if your shoes are worn out, look at the mid-sole. If there are two or more creases atop each other, then your shoe has likely lost more than 50% of its ability to support your foot from running.

  • Don't use your running shoes to train calves, since this breaks them down too quickly.

  • If you weigh more than 250 pounds, most shoes will last no longer than 60 days without breaking down.

Sources

  1. O'Connor, Francis; Wilder, Robert Textbook of Running Medicine, McGraw-Hill Professional; 2001; 696 pages

  2. Weisenfeld, Murray ed., The Runners Repair Manual St Martins Press; 1981; 193 pages

Shin Splints: Learn To Run Pain Free!
DTRRYAN@aol.com

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victoriavere

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victoriavere

I found the part about digging your hand into the arch of the foot while pressing on the sore spot. I actually did feel a little relief when i did that.

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Dec 1, 2011 5:18am | report
 
scavz

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scavz

That's some really good advice man thanks for that! Hiit is killing my shins lately.

Jun 5, 2014 5:41am | report
 
DeepSeaGoddess

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DeepSeaGoddess

Thank you for this. I just stumbled across this on a web search. Have been training for a full marathon and having a bad shin splint in my left leg. My arch was also achy/sore.....especially barefoot. I have started the suggested exercises/stretches above and I have gotten a really good running shoe with superfeet arch support insole. THANK you for this though! I was not tying the arch pain as perhaps the cause of the shin splint!!

Aug 28, 2014 7:59am | report
 
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