I am having pain at the front of my shin.

Pain at the front of the shin, known as shin splints, is a common injury. The pain comes from irritation where the muscle that lifts the front of your foot (tibialis anterior) attaches to the shin bone (tibia). The most common causes are rapidly increasing your activity level (walking or running faster, farther, hills) walking or running on hard surfaces, a change in footwear or improper footwear, or downhill walking or running. The body heals this type of injury by building scar tissue over the injury. Repeated use tears this new scar tissue which causes pain and prevents healing.

What can I do?

RICES: Rest, Ice, Compression, Elevation, Support

Elevation and compression typically are not needed for treatment of shin splints but relative rest and ice can help.

Relative rest means continuing exercise but exercising a different way or decreasing your time and intensity to allow an injury to heal:

Walking or running: Decrease your time, number of days of exercise each week, distance, and speed. Avoid hills. Try exercising on a softer surface.

Temporarily switch to a non-impact exercise such as cycling or swimming.

Ice is most effective for 48 to 72 hours following an injury. Shin splints are a repetitive strain injury so ice will be effective as long as the pain continues. Apply ice to the painful area for 20 minutes at a time. Icing after exercise will be more effective than icing before exercise.

Stretching the muscles in the lower leg can be helpful. Stretch to the point of tension but not pain. (tibialis anterior and heel cord stretches)

Anti-inflammatory medication may be helpful but talk to your doctor first.

Footwear

If the shoes you wear while exercising are worn out, do not fit properly, or are not suited to your foot type you may need to change your shoes. Your shoes should match your type of foot. Most people’s feet can be classified as high arch (supinator), low arch (pronator), or neutral arch. Along with these foot types you can also have a stiff or flexible foot. There is controversy whether or not matching your footwear to your foot type will help prevent or heal injuries but it is worth considering a shoe that matches your foot type.

Exercise surface

If you walk or run, the type of surface you walk or run on can be a factor in causing or preventing injuries. Typically a softer surface such as grass, dirt, a rubberized track, or a treadmill is better than concrete or asphalt. The only problem with the softer surfaces is that they can also be uneven which can cause foot and ankle pain and injuries for some people.

My shin pain is not improving!

Could I have a stress fracture?

Pain at the front of the shin can also be caused by a stress fracture. A stress fracture is an injury to the bone caused by overuse. The pain from a stress fracture is usually localize to a small area. Shin splints cause pain over a larger area of the shin. If you think you have a stress fracture or shin splints that are not improving despite treatment you should see your doctor before continuing an exercise program.

My shin pain is improving!

How can I go back to my usual workout without injury?

Increase your workouts gradually. A general guideline is to increase no more than 10% each week. For example, if you have been able to walk or run for 20 minutes without pain, increase your time by 2 minutes each week until you are up to your desired exercise time. The same goes for speed, hills, etc. Always change your workout gradually.

Continue with stretching exercises which are most effective if done after your workout when your muscles are warm.

Begin strengthening exercises for your lower leg muscles. (toe raises, heel raises, towel crunch)

Balance and agility training may help prevent injuries by improving the control of movements in your feet an legs. (single leg standing, eyes open, eyes closed, BOSU, wobble board)