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Body Shop: Don’t take shinsplints in stride


By Allison Pattillo - Special to Military Times
Posted : Sunday Mar 6, 2011 17:31:10 EST

When you increase your running or rucking miles, it’s normal for your muscles to complain a bit. But a dull, aching pain in the front of your lower legs is not normal. That dull ache, known as shinsplints, can sideline even the most experienced athletes.

We consulted with the military’s Human Performance Resource Center, interviewed medical professionals and spoke to athletes for prevention and treatment options to keep you running long and strong.

What is it?

Shinsplints refers to below-the-knee pain from tendonitis, periostitis (inflammation of the bone-tissue covering), stress fractures or compartment syndrome. Depending upon the cause, pain may be constant or felt during or after exercise. The area may be painful to the touch.

EXERCISES

Achieving balanced lower-leg strength will help to prevent injuries such as shinsplints. Try these exercises:

Toe raises

• Beginner: From a standing position, slowly rise up on your toes, then slowly lower back to the floor. Repeat 30 times. Do this two to three times a day.

• Intermediate: Advance by standing on one foot. Rise up on your toes 10 times, then switch legs and repeat 10 times. Do three sets per leg, twice a day.

• Advanced: Stand with the toes of one leg on the edge of a step. Your heel should drop down below the edge. Repeat 10 times. Do three sets per leg, twice a day.

Toes and heels

Spend some time each day walking on your toes. When you get tired of walking on your toes, walk on your heels. To start, aim for five to 10 minutes each.

Air Force Lt. Col. (Dr.) Anthony Beutler, chief of the Injury Prevention Research Lab at the Uniformed Services University of the Health Sciences in Bethesda, Md., recommends this self-test:

“If it hurts to press along the inside edge of your shin bone from just above the ankle bone up to the mid shin, then you likely have shinsplints.”

Shinsplints tend to hurt at the beginning of a running program and then get better. Shin pain that gets worse the more you run, makes it hard to sleep at night, or hasn’t gone away with two to three weeks warrants a trip to the doctor.

Some of the causes

Shinsplints usually are caused by high-impact exercise, such as running — especially running downhill — and by playing stop-and-start sports such as basketball.

In the military, common triggers are running on pavement for long distances, increasing running distance or speed too quickly, running in improper footwear and rucking or marching in boots.

“Shinsplints happen when the shock or force you put on your foot and leg exceeds the shock-absorbing ability of the limb,” Beutler says.

Prevention tips

Some advice to keep you running with your squad:

Check your footwear. Replace running shoes every 300 to 500 miles, and consider orthotic inserts for boots. Walk in the boots before running in them. Then run a quarter-mile in the boots and increase your boot mileage by 10 percent per week.

Don’t increase total running distance by more than 10 percent per week. Preparing your body by gradually increasing distance will allow muscles and ligaments to adjust.

Get variety in your workout. A balanced plan will help keep your body in peak form. Incorporate strength training, stretching and cross-training.

Treat the pain

The ache of shinsplints is your signal to back off high-impact exercise, at least for a while.

RICE — rest, ice, compression and elevation — is the best treatment for shinsplints. When resting, try activities that won’t aggravate your injury, such as swimming and cycling. Apply ice to shins regularly to reduce swelling and trauma. Compression can help with recovery and also limit further injury. Elevate as needed until the pain subsides.

Depending upon the injury and your doctor’s recommendations, stretch and strengthen the lower leg to promote recovery and prevent future incidents.

You may also check with your physician about using nonsteroidal anti-inflammatory drugs.

Once you’re pain free, follow a return-to-running program. Beutler’s favorite is found at www.healthyutah.org/downloads/pa/walkrunprogram.pdf.

See a doctor

Lower leg pain also may be caused by a more serious stress fracture or compartment syndrome, both common in runners.

Compartment syndrome results from repetitive trauma and overuse, with athletes experiencing swelling in the lower legs, pain, numbness and possible permanent nerve damage.

If pain doesn’t go away after two to three weeks of strengthening and stretching exercises, check with your doctor.

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