Stretching is an important part of treatment in particular stretching the calf muscles at the back of the lower leg.
This will also help prevent the injury recurring once training begins again. In some cases strengthening exercises may be beneficial but initially stretching exercises only should be done.
Stretches for shin splints
In many cases the calf muscles which consist of the larger gastrocnemius muscle and the lower soleus muscle are tight. Regular shin splints stretching exercises below combined with sports massage can release tension in these muscles helping to cure and prevent shin splints
Gastrocnemius muscle stretch
One of the most important shin splints exercises - to stretch the larger of the calf muscles lean against a wall with the back leg straight keeping the heel pushed into the floor. A stretch should be felt at the back of the lower leg. If a stretch cannot be felt then move the heel further back. Hold for 20 seconds then relax and repeat 3 times. If the athlete has particularly flexible calf muscles then a more advanced version of the calf stretch can be done on a step.
Play calf stretching exercises video.
Soleus muscle stretch
To to stretch this muscle the knee must be bent to relax the overlying Gastrocnemius. The patient should stand facing a wall with the foot of the calf to be stretched at the back. The knee of the back leg should be bent towards the wall, keeping the heel on the floor. A stretch should be felt in the lower part of the back of the calf. hold this position for 30 seconds and repeat 3 times. A more advanced version of this stretching exercise is to place the forefoot or the front leg on the wall keeping the heel on the floor and gently push the front knee towards the wall.
Play soleus muscle stretching video.
Seated shin stretches
Stretches for shin splints also involve stretching the muscles on the front of the lower leg can be difficult to achieve. It is probably more important to stretch the muscles at the back of the lower leg. The athlete kneels down sitting on their heels. Gently push down on the heels to stretch the front of the leg. Hold the stretch for 30 seconds and repeat 3 times. To increase the stretch do one leg at a time and lift up the knee of the stretching leg.
Play shin stretching exercise video.
Strengthening exercises for shin splints
Strengthening the muscles of the lower leg can begin after the initial painful, inflamed phase has passed. Strengthening should be a gradual process and exercises should always be pain free. The emphasis should be on stretching exercises and build up the load on the lower leg through exercises or running gradually.
Toe raises are a good starting point when looking to strengthen the shin muscles. Start with only a few repetitions and gradually increase the numbers. The patient should be sat with both feet flat on the floor. Keeping the heel on the ground, the patient should lift the rest of the foot up as high as possible. Hold for a couple of seconds before slowly returning the foot back to the floor Repeat 10-20 times and increase to performing 2-3 sets. Less is more with this exercise, doing too much too soon can make symptoms worse.
Play toe raise exercise video.
Calf raise exercise
To strengthen all of the lower leg muscles, perform calf raises. These can initially be performed both legs together before being progressed to single leg only. Stand with the feet shoulder width apart and knees straight holding onto a wall or similar for balance. Lift the heels off the floor as high as possible and slowly return to the floor. This can be progressed even further by standing on a step with the heel off the back and lower the heel down past the level of the step.
Play calf raise exercise video.
Dorsiflexion is the ankle movement where the toes are pointed towards the ceiling. To progress in strengthening the shin muscles resistance can be used in the form of either pressure from a partner or a resistance band. The patient sits on the floor with the resistance band looped around the toes and held at a fixed point on the floor in front. They then dorsi flex the ankle against the resistance of the band.
Play resisted dorsi flexion exercise video.
Heel and toe walking
The patient walks with exaggerated ankle movements from the heel raising up high on the toes. A variation of this is to walk the length of a room either on the toes or on the heels will help to strengthen the calf and shin muscles respectively. Make sure you do this slowly and under complete control.
Play heel to walking exercise video.
Returning to full fitness
How to cure shin splints is not just about getting pain free but returning to full fitness without symptoms recurring. Provided walking has been pain-free for 2 weeks, you can start to gradually return to running. Apply tape to the shin to support it for the first few runs and ensure you have the correct shoes for your running style or sport. After every training session apply ice to the shin for about ten minutes.
Ensure you stretch properly before each training session and after. Hold stretches for about 30 seconds and repeat 5 times. Use massage regularly as this will help prevent the muscles tightening up, hardening and putting strain back onto the lower leg again.
Below is an example of a gradual return to running program. Begin each training session with a 5 minute walk followed by a stretch.
Day 1: walk 4 minutes jog 2 minutes repeat 4 times
Day 2: rest
Day 3: walk 4 minutes jog 3 minutes repeat 3 times
Day 4: rest
Day 5: walk 3 minutes jog 4 minutes repeat 4 times
Day 6: rest
Day 7: walk 2 minutes jog 6 minutes repeat 4 times
Continue increasing in this manner until you are confident enough to return to full training.