Managing and Preventing Tibial Bone Sprains (Shin Splints)

Shin splints and tibial bone strains are the bane of many runners. As such, this injury has the distinction of being one of the five most common running injuries alongside plantar fasciitis, Achilles tendinosis, IT Band Pain Syndrome, and runner's knee(PFPS). These and other common running injuries help make running a high risk injury sport,

So what is it and what can we do about it?

Tibial bone sprains, alongside the other four injuries, is an overuse injury. This means that all five injuries are most basically prevented or managed through smart training, better form, good shoes, and strengthening exercises.

Shin splints are not actually an injury but a symptom of various injuries that may impact the tibia or shin bone. This class of strains is most common in beginning runners or those starting anew after a break.

Because bone tissue is being dismantled and rebuilt at an accelerated rate in response to exercise, weaker bones can combine with excessive training to cause bone strains. As bones are stressed they first become weaker, causing small bone fissures. With too much training, these fissures can become too concentrated and severe. This is why we feel the pain of shin splints and ultimately stress fractures if the initial warning signs are ignored entirely.

The first and most basic response to tibial bone sprains is to reduce your running as soon as you start feeling shin pain. Never run through the pain, and cautiously increase your mileage as the pain allows you too.

Ross Tucker and Jonathan Dugas recommend certain forms of cross training to help during the recovery and strengthening period. You can run slowly on a treadmill set to maximum incline in order to reduce impact as much as possible while still running. They make pains to point out that cross-training exclusively in non weight bearing forms of exercise like biking and swimming aren't a great longterm solution to shin splints because they remove the stress necessary to strengthen the bones. Non-strengthened bones will be remain weak and result in shin splints once you resume running.

Tibial bone sprains can be a bigger issue with women with low mineral density and those with naturally thinner bones in general. Eating enough, avoiding carbonated drinks, a good diet with plenty of veggies and calcium, and running can all help.

Here are some other suggestions for shin splints:

• run softer with a focus on reducing heel impact (think in terms of running more quietly)
• look for a more comfortable pair of shoes
• strengthening exercises

I'll highlight strengthening excercises out of the above list because I think it combines with running less to help with tibial strains the most. Remember, if you unable to do these exercises without pain, don't do them!

Two auxiliary strengthening exercises are heel deeps and using a balancing board to strengthen the ankle. I highly recommend doing both of these several times a week.

And to reward those who have made it this far, the number one cure for shin splints is the following: Sitting on the ground with your feet out in front of you, place your left foot over your right foot. Press your left foot down (or away from you) and your right foot up (or towards you). Hold and repeat as much as you can manage, feeling the strain of muscles getting worked. Then do the same on the other foot- right foot on top of left foot. I recommend doing this just about every day for several weeks.

Many sports podiatrists and running coaches, including myself, consider the above exercise the best one because it most directly strengthens the muscles around the shin bone. In doing so, the bones become stronger quickly without the associated impact trauma of running.

So there you have it! Listen to your pain, but fear not: tibial bone sprains are a manageable injury.