What’s the best way to treat shin splints?

DEAR DOCTOR K:

I’m on my high school track team. I’ve developed painful shin splints. What’s the best way to treat them?

DEAR READER:

I was on my high school track team, too, but based on where I placed in my races, I’m not sure anyone noticed. Like you, though, I got shin splints.

Shin splints commonly occur in runners. They cause muscle pain and tenderness along the inner side of the lower shin. Pain usually continues after exercise ends. You may even feel it when you’re resting and not putting weight on the affected leg.

Shin splints develop because of overuse of the posterior tibialis muscle in the lower leg near the shin. In most cases, this overuse is related to a sudden increase in the intensity of an athlete’s training program. You may be running faster, farther or for longer periods than before.

My shin splints developed after I trained for and competed in a one-mile race where, for the first time in history, the six-minute mile was broken! (That is, for the first time in my personal history. No, we didn’t have much of a track team.)

Even when you’re pretty sure the pain in your shins is caused by shin splints, similar pain can be caused by a tibial stress fracture, a small stress-related break in the shinbone. A bone scan may be ordered to confirm or rule out a stress fracture. So if the pain doesn’t seem to go away with rest, and comes on when you bear weight on your leg, see your doctor.

If you do have shin splints, follow the RICE rules:

  • REST the injured muscle. Take a break from running for seven to 10 days.
  • ICE the injured area to reduce swelling.
  • COMPRESS the muscle with an elastic bandage.
  • ELEVATE the injured leg.

In addition, acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil, Motrin, others), will ease pain and tenderness.

As the pain gradually goes away, start with a walking program before running again. If your shin pain returns when you walk, you will need to rest your legs again until you are pain-free for two or three days. Injured muscles take time to heal and are easily reinjured. If you return to your training too early or too intensely, your shin splints may come back.

To help prevent shin splints in the future, warm up thoroughly before running. And follow the 10 percent rule: Don’t increase the time or intensity of your workouts more than 10 percent per week. You may also benefit from exercises to strengthen the muscles in your lower legs and around your ankles.

Many great runners have experienced shin splints, rested the muscles and gone on to glory. As for me, I experienced shin splints, rested the muscles — and went on to practice medicine!