shin splints

  • Posted by a hidden member.
    Log in to view his profile

    Aug 01, 2007 2:08 PM GMT
    anyone have any suggestions on shin splints? When I try to run for my cardio I get shin splints so bad and cant run for up to a week sometime waiting for them to stop. Any suggestions on what to do?
  • Posted by a hidden member.
    Log in to view his profile

    Aug 02, 2007 2:16 AM GMT
    Being a pro dancer I have had my share of shin splints... What helped me the most was massaging the inflamed muscle close to the bone. Trust me this hurts like hell, but it most definately helps. Icing it also helps a lot. If you have time in the evening switch between hot and cold packs.
    The best thing (needless to say) is rest and making sure your footwear gives you proper support, not just for your work out, but also in daily life. Good pharmacies sell gel soles that will perform miracles. The thinker heel gels have been my friend, my best friend for years! Check them out... Have you tried a non-impact cardio work out already?
  • Posted by a hidden member.
    Log in to view his profile

    Aug 02, 2007 2:22 AM GMT
    yea, when they get to bad I do the eliptical or ride my bike, but I know I can burn more calories faster by running so I would like to do that but dont know if I can becuz of the pain. Sometimes it'll last for a long time
  • Squarejaw

    Posts: 1035

    Aug 02, 2007 3:32 AM GMT
    Shin splints are muscle soreness of the tibialis anterior (the muscle on the front of the shin). Some people get them because they don't properly warm up the muscle. You can warm it by doing grounding your heel into the floor and raising your toes as high as you can. Do that about 30 times for each foot before doing cardio.

    If you overdo it, though, you might give yourself shin splints, so be careful.

    (I read this someplace about 20 years ago, so if anyone can confirm or deny it, I'd be grateful.)
  • Posted by a hidden member.
    Log in to view his profile

    Aug 02, 2007 4:13 AM GMT
    Squarejaw (nice screen name f.y.i.) is right! Many people forget that warming up a muscle is essential to physical health. Even stretching targeted upper body muscles in between reps has proven to increase your pump. (a fun fact I just learned...)
    You might want to lay of the hi impact cardio and find another form of cardio-vascular excercise... It sounds pretty intense, and the last thing you want to happen is that this turns into a chronic thing... TRUST ME!!
    600 milligram of ibuprofen after a work-out does the trick. Or... right before going to bed. Your body restores itself at night and muscles relax themselves for the duration of your rest. Ibuprofen, a proven muscle relaxer and anti-inflamatory will do its work much much better then.

    GOOD LUCK!
  • Posted by a hidden member.
    Log in to view his profile

    Aug 02, 2007 4:27 AM GMT
    As a race walker, about the only muscle that we can really show off are our shins, as we really use them a lot. An exercise that we do in warm ups (and I understand that physical therapists use for people who have had ankle injuries) is to stand on one foot, raise the other thigh so it is parallel to the ground, and draw the alphabet with your big toe. This will force you to get a full range of motion in your foot, and you won't just roll it a few times, but complete the whole alphabet. Switch feet and do it with the other foot. This helps with mobility for the foot doing the drawing, and stability for the standing foot.
  • UStriathlete

    Posts: 320

    Aug 03, 2007 12:13 AM GMT
    it's an over issue injury. from guessing, using running as a fat burning exercise, you did too much too soon and your shins/muscles were not ready. running frequently for short time/duration 5x wk for 10-15 min is better than 2-3x wk for 30-40 mins. Acclamation!!!!!

    also how you run, injuries people. i bet you are a heel striker. get a copy of Chi running, either book or dvd.

    good luck!
  • Posted by a hidden member.
    Log in to view his profile

    Aug 03, 2007 12:38 AM GMT
    You NEED to get he right shoes for your feet. I used to get shin splints so bad I didn't run at all, I hated it. With the right shoes, and of course, warm-up stretches. I really love it. Try this link to Runner's World to help figure out what type of shoe you need.
    http://www.runnersworld.com/article/0,7120,s6-240-319--4615-0,00.html
    Once you figure out what type of shoe is best use their 'ShoeLab ShoeFinder' on the front page to see what's out there.
    It will make a difference, I can actually feel when my shoes wear out.
  • Posted by a hidden member.
    Log in to view his profile

    Aug 03, 2007 12:51 AM GMT
    This video might help too:
    http://www.runningwarehouse.com/video/buytherightshoe.html
  • Posted by a hidden member.
    Log in to view his profile

    Aug 03, 2007 1:32 PM GMT
    This has been discussed at length in this forum:

    http://www.realjock.com/topic/10794/

    It is NOT just muscular over use of the tibialis anterior, but many of the other flexors attaching to the toes and other metatarsal bones in the whole deep compartment (your lower legs musculature are wrapped in sheaths called compartments.)

    It is too long and complicated to get into here again.. Please have a look at the link above.
  • Posted by a hidden member.
    Log in to view his profile

    Aug 09, 2007 8:30 PM GMT
    I find that icy hot works after a practice, that sorts them out.

    For me, shin splints are caused by dehydration or something stupid I forgot to do to prepare myself for the workout.
  • UStriathlete

    Posts: 320

    Aug 10, 2007 12:16 AM GMT
    www.chirunning.com

    learn to run correctly. good luck!!!

    try Traumeel all natural antiflammatory cream
  • Posted by a hidden member.
    Log in to view his profile

    Aug 10, 2007 2:48 AM GMT
    I was told by my doctor a few years back to let your feet hang off the edge of the bed. Take turns with each foot spelling out the entire alphabet with your toes. It doesn't seem like much, but it should fatigue the muscle on each of your shins. This eventually helped me get rid of a horrible case of shin splints. I also put water in small Dixie cups and froze them. Once frozen, I would roll them up and down my shins - recommended by my athletic trainer. Hopefully this helps!
  • Posted by a hidden member.
    Log in to view his profile

    Aug 10, 2007 3:09 AM GMT
    What kind of physician told you to do this...? A primary care? Or a physiatrist..? By the way, there is really no such thing as a "sports medicine" doctor... You are either an ortho or a primary care with some post graduation classes here and there.. There is no such thing as a "sports medicine" residency training for MDs... You go for ortho for a min of 5 years after med school, or 3 years of internal med residency...

    "Shine Splints" as described here and other threads on this site, is mostly an OVER USE injury. Doing more exercises will just make it worse. But at least this is an open chained and not a weight bearing exercise...

    You need to rest, take the inflammatory respons down (NSAIDS meds, ice), increase flexibility (stretch), and watch your gait and shoe/orthotic wear...

    So ice is a good idea..

    I hate to question your doctor, but why would you do more active contraction exercises with an over use injury...?
  • Posted by a hidden member.
    Log in to view his profile

    Aug 11, 2007 3:35 AM GMT
    I cannot recall which physician I went to, it was back in high school. I do recall her mentioning that my gastrocnemius had been receiving more of a work out than my tibialis anterior. I guess the uneven workload or growth (which, I do not know) was her reasoning behind the pain. Sure enough though, once I began doing the exercises nightly, the pain began to subside. I guess there is more than one way to get shin splints? And more than one way to get rid of them?....
  • Posted by a hidden member.
    Log in to view his profile

    Aug 11, 2007 5:25 AM GMT
    There are, however, sports medicine fellowships for orthopedics, family practice, and this is where the bulk are, but also internal medicine and emergency medicine, and usually requires 1, in most cases, to 2 yrs beyond a regular residency. It has also been a recognized subspeciality by the American Board of Specialties since 1989. so yes, there are physicians specifically trained and who have taken time to specifically become sport physicians.
  • Posted by a hidden member.
    Log in to view his profile

    Aug 11, 2007 12:50 PM GMT
    My mistake. I was not aware that Sports Medicine fellowships were open to primary care physicians.

    This information was given to me by the ortho residences where I work. They basically told me you cannot really learn about ortho unless you have done a basic 5 year ortho residency first... And AFTER that, after you are no longer a resident, pass your board, and have your medical license, and have practiced for a little while, THEN you can apply to fellowships of specialties... The ortho team basically pretty much put down (and that is a nice word I chose to use here) "sports medicine" primary physicians and also especially physiatrists..

    I do know that many "Sport Medicine" physicians are of either primary care or physiatrists, at least in NY State, and they still refer many of their patients to ortho with ortho conditions, and seem to treat the most basic ortho conditions that can be seen by any primary care... I have only seen them do an occasional EMG here or there, and the diagnosis and rehab instructions coming from Sport Medicine physicians were most of the time very vague, not that like of the ones coming from ortho...

    I apologize for the misinformation. I will ask our ortho team more about this...

  • Posted by a hidden member.
    Log in to view his profile

    Aug 11, 2007 1:04 PM GMT
    Actually I do have a question for Wreick..

    From having seen what the ortho residences go through, they learn SO much during the 5 years of their residency. This training just cannot be replaced.

    When a primary care applies for "Sports Medicine" fellowships, what kind of ortho background do they have when going in the program...?

    How do you turn a primary care physicians into a "Sports Medicine" specialist in just 1 or 2 years...?

    I am just curious because many of the primary care and other specialty physicians at my hospital, include some cheifs of various departments, choose me as their PT to rehab their ortho conditions. They are constantly asking for advice, and it seem to me that they really have the minimal ortho background... How do you become a specialist of "Sports Medicine" in just 1 or 2 years of fellowship if you only had the training of a primary care...?
  • Posted by a hidden member.
    Log in to view his profile

    Aug 11, 2007 5:36 PM GMT
    Well yes, I don't think anyone is talking about replacing what the ortho residents learn, and yes they do learn an awful lot in five years, well mostly 4 years for the ortho part as the first year is mostly general surgery. But a lot of what they learn is not particularly related to sports medicine and sports related injuries. Yes, they are specialists in teh musculo-skeletal system, but, they must also learn how and when to operate which does, and should, take up much of their time. And their fellowships in sports medicine are separate from those of the primary care physician and much of their time is spent operating.

    A primary care physician, FP, IM and ER, are expected to know something of just about everything. FP and ER usually spend time on ortho, and definately see a lot ortho and ortho injuries outside of their ortho rotations. ALso these fellowships are, in general, fairly competitive, and someone interested in the area will probably have taken electives and spent time learning about the subject. They also won't have to worry about focusing on operatinge and learning operative technique.

    So in a sense they have different focuses. The ortho needs to know how to evaluate the condition as well as operate on it. The primary care physician needs to know how to evaluate, treat what he can treat and send to surgery what he can't. In some ways he primary care is a triage system because there is a lot of stuff that can be seen and treated without seeing an orthopedic surgeon, and a lot of it is stuff that they won't be that interested in seeing, ot at least is not effective for their time.

    You can argue whether a year is enough, but that is what has been decided. Actually I know more orthopedic surgeons than primary care sports doctors, but in either case no one stops learning once they finish their training.
  • Posted by a hidden member.
    Log in to view his profile

    Aug 12, 2007 7:01 PM GMT
    I agree that an ortho may not treat athetles, and possibly just perform joint replacement surgeries all day for the geriatric population, and not be very well versed with the needs of an athelete...

    However, atheletic injuries are primary of musculoskeletal in nature, which is ortho. So, a specialist in sprots medicine HAS to be first a specialist in this area of medicine AND then more specifically zero in the atheletic population.

    I agree taht just becasue one is an ortho does not mean this physician is a posrt medicine specialist, but it would make sense to me that any sport medicine MDs, even if not verse with ortho surgeries, has to be specialised in general ortho first and foremost...

    I am speak this way because we had a program at our hospital where a few selected PT's were recruited to triage with the ortho. These PTs' were required to attend surgeries and also every ortho conference where the attendings review with the residences the differential diagnosis procedure, including physical examination techniques, methods of radio film as diagnostic tools for specific daignosis, etc. The only thing we PTs did not understand were the actual surgical procedures. We got this training with the ortho residents as a group at least 12 hours a week for over 4 years, so we can screen the patients for ortho, determine types, views, and methods of radio films to be taken, and have the ortho attending co-sign our notes just as a resident. We assist with injections, aspirations, casting, etc..

    And during ortho conferences, we see misdaignosis by primary care psort medicine physicians quite often, such as osteolysis of AC joint misdiagnoised as a general impingment syndrome or bicipital tendonitis, RSD misdiagnoised as cellulitis, or Osteochondritis Dissecans misdiagnosed as plain DJD... The orhto team usually just put the primary care sports medicine physicians down and redicule the misdiagnosis... We hear it all..

    That is what I was pointing out, I would think to be sports medicine specialis, youhave to have the ortho expertise in atheltic injuries to make the proper DIFFERNTIAL diagnosis.. Because if it just with vague general diagnosis like DJD or impingment, or just an injection or apiration here or there, then all physiatrists physicians can do the same thing, and they are not all sports medicine specialists...
  • Posted by a hidden member.
    Log in to view his profile

    Aug 12, 2007 7:18 PM GMT
    I would like to add that, to be able to make the proper differential diagnosis and have the proper treatment plan does NOT mean this physician has to be versed in ortho surgeries... But a proper differential diagnosis is essential, as it sets up the plan for proper treatment or proper referral. Most important of all, some conditions, such as OCD, has to be properly diagnosed because DELAYED proper treatment affects the final outcome...
  • Posted by a hidden member.
    Log in to view his profile

    Aug 13, 2007 5:26 AM GMT
    Well, I can't say what all the primary care physicians learn in their sports fellowships because I haven't experienced that, but it is my understanding that they spend time in clinic with the orthopedists as well as their own clinics. As to whether the training is adquate, I really can't say, but that is what the powers at be have decided. And as with all physicians, I'm sure there are good and bad ones, and I've known some who were very good.
    And yes, if you work at a referral or teaching center you will get other's misdiagnoses, and I'm sure you get many from other orthopedists as well as the family sports Drs. And yes, most orthopedists are not without an ego, and almost every specialty rags, and looks down, on the others.
    And yes, the training may well be different, and have a slightly different focus, but I wouldn't rule a sports dr. out just because their background was in primary care.
  • Posted by a hidden member.
    Log in to view his profile

    Aug 13, 2007 5:39 AM GMT
    You got a point....

    I did not take into consideration that I work at a teaching facility where we tend to see every misdiagnosis there are...

    And you are right, ortho does have a BIG ego... I am not going to repeat what they joke about amongst eachother when other non-ortho physicians are not around...
  • DanLMT

    Posts: 6

    Mar 17, 2008 1:22 PM GMT
    I had them when I first began running 30 years ago. I have also been an LMT for 16 years specializing in sports and injury recovery. shin splints are a general term for inflamation along the anterior or lateral muscles of the lower leg and can have multiple causes

    poor shoe fit combined with flat feet and overuse syndrome or repetitive activity create micrscopice muscle and fascia tears. this all results from improper skeletal alignment due to Cranial Dural Stress Syndrome. If the cranial bones are in dysfunction and improperly and/or moving insufficiently, then neurological messages do not get sent to the muscles. Compenstaion occurs with the muscle system and injuries easily ensue.

    I have seen nearly 300 new patients in the last 15 months that have been dramatically helped with Cranial Release Technique (www.cranialrelease.com) I'm one of 3 instructors of CRT. combined with excellent sports massage, injuries heal quickly, rarely return and a new level of improved musculo-skeletal function results

    fallen arches, diabetes, infertility, overweight, fibromyalgia, migraines, sciatica, water retention, hormone imbalance, MS are just a few of the conditons that CRT has eliminated....