Shin Splints: Check again

Injury Clinic
1

Ok basically my lower leg pain is now targeted along this weird area, along the inner tibia on each leg. Check out this picture…what could possibly still be wrong with my shins?

P.S: Antiinflammatorys like advil aren’t helping. They don’t even alleviate the pain temporarily. Shin splints going on since February 06 X-Rays showed no fractures…

Also, the pain felt is normally a dull, constant pain in the area…usually when I wake up in the morning for a very brief period this dull pain isnt there…but quickly comes. Palpation of the tibia on the flat side(top) and the inner side (edge) both cause pain, and motions such as stomping, or impact activities aggravate it.

((Picture is front view of the RIGHT lower leg))

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Hey in reply to my reply in your other thread. I put the tube around the ball of my foot because it just doesnt slip there. And yes its ment to pull your foot towards you. Use as much resistance as you can. When you do it does tire out your shin muscle like it feels like youve been dorsi flexing for a long time. in other words does it fatigue the muscle opposite where you are getting pain. That is what you should aim for. DONT slack off doing them.

3

Yeah I went hard. I did it twice a day. I did it every day. I probably did it wrong, because I didnt feel it in my “shin muscle”…but to counter that I just did direct dorsiflexion work with the tube and THAT really burned my shins up.

I felt my outer calves get really worked though, and some inner calf.

How do I know that my pain isnt due to stress fractures though? X-rays didnt turn up any, but maybe I have microscopic ones or somethin? My pain is in a weird spot. I don’t think theres a tendon on that side of the tibia, where my pain is. This leads me to conclude I either have fascia, muscle, (blood) pressure or bone related damage, and palpation of the tibia hurts so maybe I have some fractures even though X-rays a few months ago said I didnt?

4

http://www.athleticadvisor.com/Injuries/LE/shin_splints.htm

Says that X-rays for stress fractures are inconclusive…also Advil can slow the healing process(i dont even feel better at ALL when taking advil)…plus i feel pain in the bone and right around the area…maybe I do have stress fractures?

5

Well when I had some really bad foot pain couple of years ago, x rays didn’t show anything, until my bone literally split. I think the way to go is by having a bone scan, since those are a lot more accurate and can detect small cracks and such.

I have experienced your shin pain as well; although I never had a bone scan, I had to take the indoor season off and do some physio along with a knee injury in the same leg…that wasn’t fun. They do recommend that once shin splits are at a bad point, your best bet is resting it and taking time 1) to let the pain go away and 2) then strengthen them and create more balance in your leg.

But since you are worrying about a fracture, I think you should have the scan. On the other hand, my physio recommended not to have a scan back then because I had to take a few weeks off anyway due to my knee pain as well, so even if I did have a fracture the shin would have enough time to recover and get stronger through exercises.

I don’t know if I’m helping here with me going off on a tangent here :smiley: .
The bottom line is: It’s sad, but if shin splints are not prevented initially and you keep “bothering” them, they’ll only get worse.

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See a doctor!!!

My guess: classic case of shin splints or perhaps a stress fracture.

Either way, it won’t get better if you don’t back off and do some rehab. And you could do more damage by trying to push it.

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its tech called shin splints, they are located more over the tibea muscle. yours is on the inside of the leg. all it is, is tendonitis. Massage till you cry, so you will have to get somebody else to do so. Tens machine, ice, stretching both calf and tibea muscle, do feet exercises. If you stop running, it will just come back, you need to run through it, but, use jogger for tempo, use distance spikes for you speed and cut the volume in half. Its a very common injury if you have been doing no running for awhile. It used to get me all the time i used to have time off, but since strengthing the hole lower leg in the gym in the last couple of yrs, i never get it anymore.

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boldwarrior- lol ive tried ALL of those. I got my shin splints about 1.5 years after beginning to sprint. I don’t see how running through the pain is going to make anything better…

But yes, my shin splints WERE over the anterior tibia muscle, and my outer calf muscle near the knee would hurt bad too…but now the pain is just on the inner shin(on the tibia and to the inner side), pretty much on the bone and the soft tissue next to it on the inner side. There’s a few spots on the tibia where if I push in it hurts quite a bit. When a bone hurts, what could that mean? lol…

Oh yeah,…I dunno if I mentioned this but I have the same pain in both shins… this sucks

Yeah I’m gonna try to set up an appointment with a doctor.

Stef- thanks for your post! how do your shins feel now?

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Honestly, I agree with you (UnlimitedSteel) that running through it is not gonna make things better… I just KNOW what kind of pain this is, and for sprinting, it just doesn’t do any benefit… You lose your spring, it’s hard to get a good explosive start, once you’re done with one sprint, you’re pretty much done with the whole session because more pain comes afterwards… it’s frustrating and counter productive.

With me, the key to making my shins better was taking off from running when they got really bad (like you), and then gradually get back into running (this was like 6 weeks after I stopped…it took a while, but I’m known for not taking “completely” off…I was always doing something, non-track related though)

Last year, they ALMOST came back in the fall. I fought them to death (literally :slight_smile: ) when I felt the SLIGHTEST hint of irritation. See…that’s the key… As soon as you feel the slightest, you are immediately reminded that your calves are too strong for your shins, or simply your shins are just not strong, or your calves are just not stretched enough…or all of the above (my case :rolleyes: )

This year, I have had some MINOR irritation as well, and I’m walking on my heels a lot, stretching my calves all the time during lifting sesssions especially when there’s not much to do during breaks (other than abs…), doing all tempo on grass, having good warm ups. IT WORKS… There are sessions when I don’t feel absolutely anything. When I feel something is usually when the weather is crappy and when I have a not so thorough warm up. I am pretty confident that they won’t give me further problems, since I was able to fight them last year as well.

  1. Let your shins recover!
  2. Strengthen your shins and stretch your calves a lot (there are a lot of shin strengthening exercises, that you probably already know and have tried, but remember: they don’t really work while the pain is there, you have to let the pain settle first)
  3. SLOWLY get back into running, on soft surfaces first.

It’s really not that big of a deal taking some time off and taking care of this, because I’m sure you’ve felt that 1.5 years training in pain has been only frustrating and not fun!! Who wants to train seriously when it’s not fun??
I have the hardest time taking even a couple of days off, but some things need attention to see good results.

Besides…you can always do tempo workouts in the pool and biking interval speed sessions, and trust me… they do work to some extend… I pr’ed couple of years back both in the 200 and 400 just coming from pool and bike workouts that lasted 6 weeks (I was out with stress fractures then). You can make some good workouts out of them…

Enough for now :slight_smile: Let us know how it goes.

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I know what you mean with the pain that feels like its on the bone on your inside of your shin. Like it hurts to touch. It is not a stress fracture. Basically strech out the calf and achilles. The problem will be either your calf is too strong compared to shins/ vice versa. The tubing excercise I gave u is designed to strengthen both to a point where they will eventually be in equilibrium. Im out of advice from this point on, so good luck :slight_smile:

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UnlimitedSteel:

i managed to solve (well not entirely, but im optimistic) my athletes chronic (like 1 full year) shin splits basicaly within two weeks of active rest and lots of massage.

what i found was this, the tibialis anterior was tight and inflamed, the extensor was just a mess, and his calves were like rocks.

Initially the pain was so intence i couldnt even touch him (much less do massage) directly on the shin. So i started by feel to loosen up all the suporting structures right up to his lower back. Truth be told, his hams and glutes where not that bad, so the work was minimal, but his shins where fucked up. So after like two or three masages it got to a point where i could touch his shins directly and i started doing a “peeling” kind of motion, initially to the muscle and currently i can touch the bone with minimal pain. Now his back in training and i just maintain the loosened calfs with soft massage during training and deeper after some pnf streches in the end.

though it could very hard doing the massage your self, so get someone to do it for you

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you should check you can properly evert the foot. If you can’t then often you run on your toes which leads to tightness down the medial boarder of the shin. This is especially true in long distance runner.

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what would be the proper procedure for massaging the shins?

Update on my situation

It’s almost 2007, and my shins still hurt. I had blood work done to test for rheumatoid arthritis, and the rheumatologist doesn’t think I have it. Because I told him I took out the orthotics after trying them for 1.5 months, he said to try them for a longer period of time, perhaps 3+ months, and he prescribed me 150mg of ketoprofen daily (its an anti-inflammatory).

He also said he thinks I have periostitis, which is an inflammation of the periostium of the tibia. It’s basically inflammation right around the bone, but not actually the bone I guess. This would make sense, considering my bone is tender to the touch, especially right above my ankle.

So basically, I’m back to where I started. I’m very doubtful that my shins will ever feel painfree or normal again. It’s been 11 long months.

I don’t even know whether I should ice or heat my shins, or if I should just leave them alone? I dunno if I should even try walking in water? How about EMS on my shins?? Would bench pressing aggravate the shins too much?

I know that a couple weeks ago all I did was do 400m jog once a day for probably 7 days straight and my shins were actually feeling better, but then I got sick one day and my shins started feeling worse again. Of course when my shins WERE feeling better I also upped my water intake from minimal to about 8 Liters a day. I admittedly don’t drink much water. I don’t really drink water much, instead I’ll drink juices or milk. Still not much though.

Yup, I’m clueless on what to do!!!

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The periosteum is a thin layer of connective tissue that covers the outer surface of a bone in all places except at joints (which are protected by articular cartilage). As opposed to bone itself, it has nociceptive nerve endings, making it very sensitive to manipulation. It also provides nourishment in the form of blood supply to the bone. The periosteum is connected to the bone by strong collagenous fibers called Sharpey’s fibres, which extend to the outer circumferential and interstitial lamellae of bone.

The periosteum consists of an outer “fibrous layer” and inner “cambium layer”. The fibrous layer contains fibroblasts while the cambium layer contains progenitor cells which develop into osteoblasts that are responsible for increasing bone width. After a bone fracture the progenitor cells develop into osteoblasts and chondroblasts which are essential to the healing process.

[edit] Disorders of connective tissue
Various connective tissue conditions have been identified; these can be both inherited and environmental.

Marfan syndrome - a genetic disease causing abnormal fibrillin.
Scurvy - caused by a dietary deficiency in vitamin C, leading to abnormal collagen.
Ehlers-Danlos syndrome - a genetic disease causing progressive deterioration of collagens, with different EDS types affecting different sites in the body, such as joints, heart valves, organ walls, arterial walls, etc.
Loeys-Dietz syndrome - a genetic disease related to Marfan syndrome, with an emphasis on vascular deterioration.
Osteogenesis imperfecta (brittle bone disease) - caused by insufficient production of good quality collagen to produce healthy, strong bones.
Fibrodysplasia ossificans progressiva - disease of the connective tissue, caused by a defective gene which turns connective tissue into bone.
Spontaneous pneumothorax - collapsed lung, believed to be related to subtle abnormalities in connective tissue.
Sarcoma - a neoplastic process originating within connective tissue.

One could visit a specialist and check these out. Perhaps see a nutritionist to see if your lacking something? Glucosamine perhaps?

I would ICE your shins every night.
Recheck your shoes and orthotics
Massage, try using a antiinflamitory gell, and try EMS on recovery settings.
You may need to do pool work till you get on top of them?

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Have you takin any time off from running. And when i mean time off i mean nothing, no warmup or anything?

If you want to continue training, pool work for tempo and heavy weights will be okon the high intensity. Also try plyos straight up where the ground will meet you, like jumping up onto a platform or mat as it it will be much easier on the shins. I had shin splints and weights did not bother me at all. Also max strength EMS. Use the ems machine in a pulsing mode to help loosen the calf. As sometimes a tight calf can aid in creating pain.

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boldwarrior- thanks a lot for your reply! I bought myself new shoes, and the orthotics I have are the smallest kind I could get, so they would be able to fit into track spikes. They’re not completely rigid, but they’re custom. I dunno if that means my orthotics are inferior or not built out of something rigid enough for me.

I didn’t know they made anti-inflammatory gels…unless youre talkin about stuff like BenGay

You think I should just use the lowest frequency(2hz) and put the pads around the bone?

Hawaiian- yea i took off months and months…they only improved minimally. You really think plyos like those will be alright? I really don’t want to aggravate my shins.

dont you think ems should be used at light intensity on the shins?

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youre right about the low intensity. Pulsing is at very light strength, so you will get more of a flush and help with blood flow, you wouldnt want to do max strength on your calf if there already tight.

As for the plyos because the ground is meeting you at the you do not put much force onto your legs to land. But obviously youre the best judge of the pain and if it hurts stop. If you have a mat or something soft to land on or able to land on your butt thatll help. I always found it was the impact from hitting the ground on landing rather than the push off that would make my shins hurt. Thats why weights and plyos up should be ok.

Did you get any therapy on your time off, or continue the strength exercises so that when you started up again you would be alright. I find that neglecting from my excericses make my shins hurt.

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Good point actually. I might not do the plyos though, just to be safe.

Phys therapy helped a little, but not that much I guess.

For some reason, stuff that shouldnt make me feel better makes me feel better. When I ran 400m once a day for 7 days straight, I was feelin better, but then for some strange reason on the 8th day my shins started feeling worse again.

Do you think squats and deadlifts are ok to do?

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weights should be ok. unless your doing crazy heavy weights, like over 2-300kg, doing farmer walks or stuff.

as per the plyro’s, have you seen the gpp dvd? try using a med ball to throw and land onto a high jump mat.

as what HS said, ems on low settings to flush blood into area.

Perhaps even try Strapping for a few weeks too?? Its worth a try. strap the whole lower part of your shin, and around your arch, that should take care of needing arch supports too, if you tape correctly. There should be photo’s someplace on the net, just google “tape strapping, ankle” or so?? bound to be picks someplace, particually netball, football and soccer sites.

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Ahh I don’t have the gpp dvd. Maybe I should think about investing in some dvds though.

How often would you be jumping and throwing the ball?

Thanks for the help :slight_smile: