Member Case Study: Shin Splints and Compression Socks

author : AMSSM
comments : 1

ASK YOUR QUESTION 

Member Question from TOGAF16

I was training for my first 1/2 marathon ever and I had been running for about three months prior to actually the start of the training without health problems. I did most of my training on a treadmill and was running at about a 1.5 degree incline. No issues until I tried to introduce some interval training. It went well for the first week until I did 8x400m runs. After that I had really bad shin splints. I bought some compression socks and I think they worked but maybe just mentally. I did fine in my 1/2 marathon but was surprised that so few people wear them. Do they actually work? If so, when should I wear them during or after the runs?

Answer by Andy Peterson, MD
Member AMSSM

Hi Rex – I detect two distinct questions:  1) What causes shin splints and what can I do to treat them; and 2) do compression socks work?  Both are excellent questions.  

First, shin splints, or medial tibial stress syndrome (MTSS), is a remarkably common injury among athletes in running and jumping sports.  Typical symptoms include pain along the middle or distal third of the posteromedial tibia.  Symptoms generally come on gradually and are aggravated by weight-bearing activity.  There is typically a diffuse area of tenderness along the posteromedial tibia.  By definition, this area of tenderness should be at least 5 cm long.  A more discreet point of tenderness is concerning for a stress fracture or other bony injury.

MTSS is caused by a mechanical overload on the tibia.  This is the same mechanism of action as stress fractures, and many sports medicine providers consider MTSS and stress fracture to exist along a continuum of bony overload injury.  It usually occurs when athletes increase their training volume or intensity.  There is strong evidence that foot/ankle overpronation and female gender are risk factors for developing MTSS.  There is some weaker evidence that higher BMI, greater hip range of motion, and higher calf girth are also risk factors.  MTSS is less common in runners who run on softer surfaces, such as dirt trails, and those who use shock-absorbing insoles in their shoes.  However, no stretching, strengthening, orthotic, medication, or dietary supplement has been shown to prevent MTSS and no treatment has been shown to be more effective than rest for treating MTSS.

This brings us to your question about compression socks.  Unfortunately, no study has evaluated the effects of compression socks on the prevention or treatment of MTSS.  There is a common perception among the endurance sports community that they do something and a recent study sheds some light on this phenomenon.  Scientists in New Zealand had competitive runners run in compression stockings of varying compression, including a control stocking that didn’t provide any compression.  Runners had no difference in any measure of performance or running physiology, but did report feeling more comfortable when wearing low-grade compression stockings while running.  It has been previously reported that compression stockings decrease delayed onset muscle soreness of the calf and that they may improve running performance.  However, these findings are controversial and a recent well-done study refutes the notion that compression garments have any effect at all.

In summary, your shin splints were most likely caused by your sudden increase in running intensity.  Rest is the best treatment for this injury.  You have noticed that your compression stockings make you feel better when you run.  This has been noticed by other runners and is supported by the scientific literature.  There is conflicting evidence as to whether or not they improve performance or prevent muscle soreness.  There is no evidence that they prevent any injury or improve recovery when worn between bouts of exercise.

Andy Peterson, MD
University of Wisconsin
Madison, WI

References:

1.    Moen MH, Tol JL, Weir A, Steunebrink M, De Winter TC. Medial tibial stress syndrome: a critical review. Sports Med. 2009;39(7):523-546.

2.    Ali A, Creasy RH, Edge JA. Physiological effects of wearing graduated compression stockings during running. Eur J Appl Physiol. Aug 2010;109(6):1017-1025.

3.    Ali A, Caine MP, Snow BG. Graduated compression stockings: physiological and perceptual responses during and after exercise. J Sports Sci. Feb 15 2007;25(4):413-419.

4.    Kemmler W, von Stengel S, Kockritz C, Mayhew J, Wassermann A, Zapf J. Effect of compression stockings on running performance in men runners. J Strength Cond Res. Jan 2009;23(1):101-105.

5.    Sperlich B, Haegele M, Achtzehn S, Linville J, Holmberg HC, Mester J. Different types of compression clothing do not increase sub-maximal and maximal endurance performance in well-trained athletes. J Sports Sci. Apr 2010;28(6):609-614.

Rating

Click on star to vote
34784 Total Views  |  478 Views last 30 days  |  100 Views last 7 days
date: September 9, 2010

Author


AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

Author

avatarAMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

View all 354 articles