Shin Splints & Stress Fractures
Written by Dr. Lucas Szczepanik B.Sc., D.C.
Every runner will experience some kind of foot, leg, or knee pain before their running career is over. There are a number of factors involved, such as the type of training surface, shoes, training volume, intensity (hills?), and weather conditions. These factors play a role in the development of overuse injuries within the lower extremity.
Shin splints, stress fractures, and chronic compartment syndrome are possible consequences of improper training, and share a similar mechanism of injury. While running your feet are constantly being impacted into the ground/running surface. Each time the foot strikes the ground a shockwave travels up the leg. This energy must be absorbed by the musculoskeletal system and places extra stress on the muscles, joints, ligaments, and bones of the feet and legs. The harder the running surface, the greater the energy needed to be absorbed resulting in greater chance of injury. Grass, dirt, asphalt, and concrete represent the increasing level of hardness. Training on concrete is very hard on the body and should be avoided as much as possible.
Shin splints are simply a weakening of the muscles in the lower leg. It is the repeated cycle of pounding and pushing off the ground that result in muscle fatigue. This results in increased forces being placed on the muscle attachments to the bone. It is the inability of the muscle to handle the stress that causes the leg pain. If the stress is continued the forces will cause a separation of the muscle to the bone and can result in a stress fracture of the bone. This represents a more extreme case, but a possible consequence of improper training.
Fallen arches and improper foot bio-mechanics can lead to similar stresses being placed on the muscles of the calf. Rather it is a postural abnormality in the foot, or a lack of motion within the joints of the foot, this needs to be corrected in order to avoid further injury. A Doctor of Chiropractic may help to improve joint motion within the feet, as well as analyze a possible dysfunctional relationship between the low back, hips and feet. If the feet can be pinpointed as the cause of the added stress, then corrective footwear may be appropriate. A common approach is the use of custom made orthotics. The orthotics will help support the bones of the feet, removing the added stress to the calf muscles while running.
The treatment of shin splints is dependent on severity. The first thing to do is to stop running until the muscles heal. Placing continued stress on the muscles will only slow the healing and may progress to other problems such as stress fractures. The next thing to do is to analyze your training routine for possible causes of overuse. A common mistake by runners is returning to the same routine that caused the injury in the first place. Analyze the running surface, type of shoes, training intensity, training frequency, and weather conditions. The recognition of a pattern in training is the key to changing your routine for the better. Stretching and strengthening the calf muscles, Myofascial Release Therapy, and range of motion exercises are essential to the healing process and should be provided by a healthcare practitioner. If you experience calf and foot pain, please consult a healthcare practitioner.