We provide this free health resource to visitors of the Community Room of SeniorSSuperStoreS in an effort to keep baby boomers, seniors and the elderly informed of matters that can affect their lifestyle.

Running is a favorite exercise for many people, but it can also lead to injury if runners do not take special precautions while training. One of the most common injuries experienced by runners is medial tibial stress syndrome (MTSS), better known as shin splints, which affects the front of the leg between the knee and ankle.

Shin splints are a result of repetitive pounding on hard surfaces and excessive use of the foot dorsiflexors (muscles which pull the foot in an upward direction). This pounding and muscle overusage leads to a stress reaction in the tibia (the bone in the lower leg) and the tissue surrounding the tibia. Once stress is placed on this area, damage has been done to the soft tissue, and continued activity will only worsen the inflammation and increase the pain, usually described as a dull ache along the shin.

There are four general stages or grades of shin splints. In the initial stage, shin splints cause mild pain while resting or at the beginning of a workout, which eases up or disappears during exercise and then returns after the workout. This initial stage is considered a grade one injury.

As the injury progresses into grade two, the pain occurs during a workout, but it is not so painful that the patient stops running. A grade three injury involves intense pain which interferes with running; some sufferers may no longer be able to run because of the extreme pain. When the injury has advanced to the point where the pain affects a person’s normal daily activities such as walking and climbing stairs, it is considered a grade four injury.

Many runners wait until their injury has reached a grade four before seeking medical treatment. It is better to begin treatment when the pain first occurs so minimal damage will result and recovery will be much quicker, allowing you to continue running and exercising.

Controlling the pain and reducing the inflammation are usually the first steps in treating shin splints. Ice and anti-inflammatory drugs are used to relieve the pain. Patients with a grade one or two injury are usually asked to reduce their running distance and intensity for a few weeks to allow for healing. For those with a more serious injury, running may be prohibited for a short length of time while the shin splints are treated with ultrasound using hydrocortisone cream or dexamethasone gel, exercise to stretch and strengthen, and ice.

Finding the cause of the problem and modifying the underlying factors is an important part of effectively treating shin splints. Factors contributing to the onset of shin splints may include: changes in a person’s running schedule; new or altered training techniques; increased frequency, intensity or duration of workouts; new running shoes or change in running surface.

Once the underlying factors are discovered, the physical therapist can offer suggestions to modify your running workout and help reduce the risk for a recurrence of the injury. Physical therapists also may recommend specific exercises to build up the strength of the muscles in the lower leg and ankle and stretches to increase flexibility especially of the heel cord.

For both beginner and advanced runners, it is imperative that you design your workouts to match your body’s fitness level. Pushing yourself too hard may result in injury. Gradually increase your intensity, speed and distance.

Running shoes also play an important role in your safety. Make sure you choose a shoe that provides sufficient support and replace them about every six to eight months if you run regularly (depending upon your running frequency and terrain, this recommendation may vary).

You may also want to consider changing your running terrain to reduce your risk for shin splints. Running on an indoor track may be safer than running on pavement.

If you think you may be at risk for developing shin splints, talk with your doctor for recommendations to modify your training techniques and make running both a safe and fun exercise.

(Courtesy of David Vaughn at Vaughn, Buchanan Shelley and Associates, Physical Therapists, in Greenville, South Carolina, phone 864-234-5842.)