First Steps to Take for Shin Splints Treatment

Shin splints, or medial tibial stress syndrome, can be a painful condition that limits your ability to walk or run normally.  Physical therapy for shin splints involves decreasing the inflammation in your anterior tibialis muscle and tibial attachment site of the muscle while working on improving the bio-mechanical impairments that may be causing your problem.

Shin splints can be a scary condition.  One day you are walking or running normally, and the next day it feels like sharp knives are being pressed into the front of your lower legs.  And usually, the pain from shin splints comes on for no apparent reason.

If you are experiencing shin splints that limits your ability to walk or run, it is recommended you see a doctor or physical therapist for treatment.  Here is a list of some good ideas for initial self-management of shin splints and some easy things to do to take care of the problem.

1
Don't Panic

Shin splints may prevent you from running.
Your physical therapist can help evaluate and treat your shin splints. Getty Images

 When the pain in the front of your legs strikes, you may begin to panic.  The pain with shin splints seems to come from nowhere, and it may last for a few hours after exercising.  You may be wondering how long you will have to deal with shin splints and how the pain will affect your walking and running.

If you have shin splints, first do not panic.  Although the name "shin splints" sounds horrible (think of splintering wood), it really is a muscular problem, and often a simple solution can help put an end to your shin splints.

2
Take a Break

Usually the pain from shin splints is rapidly abated with rest.  The problem is that the pain comes back with activity.  A short period of rest and avoidance of the aggravating activity may be in order to help manage your shin splints.  That means if you are a runner, you must stop running (for a short time).  Rest and recovery can be one of the most important phases of your exercise and rehab routine.

Complete rest is not recommended for shin splints.  The P.O.L.I.C.E. method of injury healing is a good acronym to follow. Protect your injured shins for a short time, then start an optimal loading strategy to get things moving again.  Your physical therapist can help formulate a plan of attack for your shin splints.

3
Visit Your Physical Therapist

You may feel like you can tackle shin splints on your own, but the best way to manage the pain is to visit your physical therapist.  Why?  Because your PT is trained to evaluate your condition and assess all bio-mechanical impairments in your body that may be causing your shin splints.

By gathering all available data, your physical therapist can make an accurate physical therapy diagnosis.  Proper diagnosis equals proper treatment.

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4
Get a Video Gait and Running Analysis

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Echo/ Getty Images

Sometimes the bio-mechanical impairments causing your shin splints may be difficult to see while your physical therapist is watching you run or walk during a gait analysis.  Your body simply moves too fast to spot all the nuances that may be contributing to your pain.

A video running or gait analysis allows your physical therapist to spot the small bio-mechanical faults that often contribute to shin splints.  Your PT will be able to slow the video down, and he or she may be able to measure joint angles with a specialized computer program.  This ensures that you get the right treatment and exercise prescription for your shin splints.

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5
Perform Stretching Exercises

A towel can be used to stretch the Achilles tendon.
Use a towel wrapped around the ball of the foot to stretch the calf muscle. Brett Sears, PT, 2012

Gentle stretching of the muscles around your shin and lower leg may be in order to manage your shin splints.  Stretching your anterior tibialis and calf muscles are great ways to ensure that your foot and ankle have adequate mobility to function well. 

6
Perform Ankle Strengthening Exercises

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If your physical therapist finds weakness in various muscles around your ankle and foot during your initial evaluation, you may benefit from performing exercises to strengthen those muscles.

Exercises for improving calf strength may be necessary, and a resistance band can be used to strengthen your peroneal muscles and anterior tibialis.  Don't forget to also work on the intrinsic muscles in your foot that help support your foot's arch with towel scrunches and arch doming exercises.

Balance exercises may help to stabilize your lower extremity, and this can take stress off your anterior tibialis.  Your physical therapist may use a BAPS board while you are at therapy to improve your balance and proprioception.

7
Perform Hip and Core Strengthening Exercises

Engage the abdominals, staighten your leg, and slowly lift your buttocks. Brett Sears, PT 2011

If your physical therapist only focuses on ankle strengthening exercises during your shin splints rehab, you are likely missing out on an important component of treatment.  Many times proximal weakness of the hip muscles, like your gluteus medius, contributes heavily to shin splints.

Your hip muscles help to control the position of your foot and leg when walking or running.  Weakness in your hips means that your foot is in the wrong position when it hits the ground and when you push off while running.  This can place increased stress through your lower leg muscles and irritate your anterior tibialis on the front of your shin.

It is a good idea to incorporate hip strengthening exercises into your shin splints rehab.  Your physical therapist can show you which exercises to do and how to do them properly.

8
Check Your Footwear

While scientific evidence doesn't clearly prove that foot position affects shin splints, you may want to check your shoes to look for uneven wear and tear. Scuff marks on the heels of your shoes may indicate tightness in your calf muscles.  Uneven wear on one side of your shoe may mean that your foot is in the wrong position when it hits the ground.  This may make your foot overwork to be in the correct position which can over stress your anterior tibialis.

Avoid high heels, and flip flops are probably not a good choice either.

If shin splints are limiting your running ability, check the mileage on your running shoes.  More than 500 miles on your shoes means it is probably time for a change.

Your physical therapist is qualified to check your shoes and foot position and make recommendations for proper footwear to treat your shin splints. 

When to See a Specialist

You can start treating your shin splints by resting and seeing your physical therapist. Sometimes the cause of your shin pain may be due to something else, like a stress fracture. If your symptoms last for more than a few weeks with no improvement at all, you may need to see a specialist, like an orthopedic doctor, to rule out any sort of sinister lesion. Shin splints can cause significant pain and limit your ability to walk or run normally. By starting a self-care regimen early and by following some simple advice, you can be sure to quickly and safely get back to your normal activity.

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