Dr. Allan Horowitz, published newspaper article, The Liberal, Copyright January 9, 1991

Dear Dr. Horowitz:

I have had shin splints on and off for about a year. I have taken muscle relaxants, anti-inflammatories and Tylenol. I have iced my shins and rested, but the pain returns every time I try to resume my running. I run approximately three miles a day, five days a week.

I have no other problems and nothing else hurts. I have been to a sports injury clinic but they just told me what my problem was and suggested I have ultrasound therapy.

This clinic was too far away from my office and it would have been impossible for me to attend as regularly as they suggested.

What exactly are shin splints and how can I stop them from bothering me?

Answer:

Shin splints is the term used to describe pain along the inside part of the shin (lower leg) usually half way from the knee to the ankle.

This pain is usually the result of an unconditioned athlete trying to do too much or a good athlete trying a new running or training style. Even walking around or standing on a hard concrete surface for several hours can cause shin splints. Running on a banked track or the slanted shoulder of a road, wearing poor fitting or improper running shoes or running or jumping excessively without a proper warm-up can all cause shin splints.

FEEL THE PAIN

Doctors and chiropractors who treat this condition will talk in terms of tibial torsion, foot pronation, hip rotation and heel eversion, but you don’t need to know what any of these terms mean to feel the pain.

Your pain will be felt as a dull ache which will usually be relieved by rest and ice.

Refraining from the activity will help stop your pain, but as soon as you return to the offending event your pain will come back.

This is what actually happens when one has shin splints: when the foot is on the ground the attachment of the posterior tibial tendon is pulled if one of the above situations is occurring, i.e. poor fitting shoes, hard or uneven running surface, pronated feet, etc.

If this tendon is continuously pulled away from its attachment to the bone, tendonitis will result. This causes pain.

If you stop the activity and fix the problem you will not have a problem.

If you try to run through the pain then a condition known as periostitis results. This is an actual inflammation of the bone itself and this is when the problem becomes more chronic and difficult to treat.

Ice massage (rubbing the shin with ice for 10 minutes) and rest will help the symptoms subside.

You then have to find out what the cause of the shin splints are.

Do you have flat feet? Are your feet pronated? Are you running with your hips rotated too much? Are you running or training on a correct surface? Are you warming up properly? Are your shoes correct?

You need to be assessed by a professional who can look at your situation and decide on the best route for you to take to help alleviate your problem.

In my opinion, prescribing medication without analyzing the full biomechanical situation is useless.

That is like a doctor prescribing aspirin to alleviate the headache of a man who keeps banging his head against the wall. If he stops banging his head, he won’t need the aspirin.

If the clinic you attended is too far for you, find another one. Most doctors and chiropractors either treat shin splints or know someone who does.

SOLVE PUZZLE

By “treat” I mean alleviate the pain, solve the puzzle as to why the pain is there and then do something to prevent the pain from returning.

Next week a word on orthotics, which are the hottest thing on the market since the pet rock.

Orthotics can sometimes provide the answer to shin splints immediately, without the patient changing anything else. What are these things we call “orthotics?” Next week I will let you know.

Allan Horowitz D. C., is a Richmond Hill chiropractor and writes this public service column. He will attempt to answer readers’ questions on topics such as back pain, headaches, nutrition, sports injuries etc.

Address your questions to him care of The Liberal, Box 390, Richmond Hill, L4C 4Y6.