Shin Splints Rehabilitation

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Shin splints treatment and rehabilitation includes initial first aid during the acute painful stage as well as longer term exercises and stretching that will help prevent shins splints recurring.

Aim of rehabilitation

The following guidelines are for information purposes only. We recommend seeking professional advice before attempting any self treatment. The aims of our shin splints treatment and rehab program are to reduce pain and inflammation, identify causes, improve flexibility and gradually return to full fitness.

The time scales needed for each stage will vary considerably depending on the severity of each individual case and also the commitment to treatment advice.

The full rehabilitation process may take anywhere from 3 weeks to 12 weeks. Only move from one stage to the next when you can achieve all exercises and tasks free from pain.

Reducing pain and Inflammation

One of the best shin splints treatments involves resting from activities that may cause pain. Stay off your feet as much as you can. Maintain fitness by swimming or cycling provided this is pain free.

Cold therapy for shin splintsApply ice or cold therapy. Cold therapy can be applied in a number of ways including specialist cold therapy wraps providing more convenient cold therapy and compression. Cold can be applied along the shin and repeated every 3-4 hours or at least 3 times a day. The tissues along the shin are very superficial so ice should only be applied for only 10 minutes at a time. Do not apply ice directly to the skin as it may burn. Continue this for at least 3 days.

Shin splints tapingTaping the shin is a good way of helping the leg to rest if you cannot avoid being on your feet. It will support the muscle attachments at the sore spot on the shin taking some of the pressure and strain off the tissues.

NSAID (Non steroidal anti-inflammatory drugs) e.g. ibuprofen may help in the early stages. Always check with a Doctor before taking any medication. Do not take Ibuprofen if you have asthma.

Shin splints stretchingGentle stretching of the calf muscles at this stage can be very beneficial. Hold each stretch for 30 seconds at a time and repeat at least 3 times a day. After the first 3 days, sports massage to the calf and shin muscles can be used. This should initially be quite light around the painful shin, but can gradually become deeper over subsequent treatments as pain eases.

Shin splints treatment: foot biomechanics

In many cases of shin splints, the cause is related to the way we move. Poor biomechanics can increase the load on the tissues. Failure to correct this is often a reason the injury recurs at a later date.

Over pronationIf your feet roll in or overpronate excessively then this can contribute to the strain on the lower leg. If the foot rolls in then the lower leg will also rotate inwards, making the surrounding muscles work harder than they normally would. In addition the bones of the ankle will not 'lock' properly during the running action, again causing the muscles to take the strain rather than the bones.

This can be corrected by orthotic inserts or insoles. Off the shelf orthotic inserts and heat moldable inserts are also available and are suitable for most patients. Check with a Doctor or professional if in doubt. The inserts should be worn at all times. Not just when training. Your feet are under tension even when standing.

One way of telling if you over pronate is by looking at your footwear. If you tend to wear out the inside front of your shoes then this is a strong indication that something is not quite right.

Stretching & strengthening

Calf stretching on a stepOnce day to day activities are pain free, flexibility and strengthening exercises can begin. Stretching the calf muscles can become more vigorous, using the heel drop method which involves stretching off a step. Stretching the shin muscles can also start, albeit very gently.

Sports massage should continue regularly gradually getting deeper but still avoiding the surface of the bone. Strengthening the shin muscles may help prevent shin splints recurring. Start off by performing toe raises, provided this is pain free.

Shin stretchingDon't be tempted to return to exercise too quickly! This mistake is easily made but the condition will just return if a full rehabilitation program is not followed.

Start to add walking to your shin splints treatment programme. Very gradually increase the speed and duration of your walks before incorporating hills provided you remain pain-free. Remember to always warm-up and stretch before and after activity.

Returning to full fitness

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.

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