Member Case Study: Shin Splints?

author : AMSSM

comments : 0

I've rested them for 6 weeks, twice. I've had Active Release Therapy, massages, I'm doing Trigger Point, and stretching. Yet, I'm still having issues and can't get above 3 miles.

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Member Question from LonghornBuckeye
"I'm a second year triathlete, age 52. After laying off for 1.5 months in the winter from last year, I started training again in January. After three weeks I started developing shin splints in both legs.

I've rested them for 6 weeks, twice. I've had Active Release Therapy, massages, I'm doing Trigger Point, and stretching. Yet, I'm still having issues and can't get above 3 miles. When resting they go away, but as soon as I start running again, there back. The only other variable is shoes. I bought new running shoes for Christmas-  Brooks Glycerin 7, the exact same shoe I used last year. Is it possible the shoes could be bad? I've tried running in my shoes from last year, and it is better. But my training is really hampered with me not being able to run."

Answer from David Westerdahl MD

Member AMSSM:

“Shin splints” broadly describes pain along the lower legs occurring with exercise. Commonly it refers to stress along the inside of the tibia or inflammation of the lining of the bone. It generally occurs on the lower half of the tibia above the ankle. It usually occurs from repetitive activity that leads to breakdown of the involved tissues.

My concern from what you describe is that your symptoms started 3 weeks after resuming training in January. Stress fractures can have a similar appearance to shin splints. Stress injuries can occur with a rapid ramp up of training after a period of rest. Stress injuries can persist despite short periods of relative rest. ART and massage can be useful for many sports injuries, but are of limited use in treating a stress fracture. Stress injuries can occur in men or women. Women need to be aware that the female athlete triad can predispose them to stress fractures as could low vitamin D levels.

I would encourage you to see a local sports medicine physician with an orthopedic or primary care background as you should have an Xray and/or bone scan to evaluate this leg pain. A bone scan can be helpful in differentiating shin splints from a stress fracture.

Brooks Glycerin sneakers are an excellent shoe that is a neutral, cushioning shoe that may not be the correct running shoe for you. I would encourage you to get additional feedback on your arch and hindfoot alignment as that is important in selecting a cushioning vs stability type running sneaker.

Treatment of shin splints should focus on stretching exercises for the calf muscles. Strengthening exercises for the soleus and posterior tibialis muscle are very important as well. Also, try to reduce overpronation through appropriate footwear and inserts.

David Westerdahl MD | Sports Medicine | Department of Orthopedics
2950 Cleveland Clinic Blvd | Weston, FL 33331 | (954) 659-6164 | www.clevelandclinicflorida.org

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date: August 24, 2009