Tuesday, June 20, 2017

Shin Splints! What has worked for me...

So here at Light-Minutes Away, our lifestyle often involves pushing our human physical limits a bit beyond design and sometimes this results in needing to do some self-tuning/correction.

If you're hurt/in pain from running, we highly recommend finding a good sports practitioner to set you straight and understand you situation exactly.  (We are not physicians and don't want to set you astray)

However, here's a little info from my experience with posterior (inside of the calf) shin splints that I seem to get every few years when pushing my limits (hard speed work, striving for too many "PRs" (personal records), long runs of increasing distance too quickly).   My physical situation is obviously unique, I have my own knee problems, back problems, hip problems, stride issues... but here's what works for me.  (First, I went to a great sports therapist and most everything I learned I got from a professional)

Shin splints (Or MTSS - Medial Tibial Stress Syndrome) usually get their start when something is extremely tight and out of whack.  I keep a pretty detailed running log and looking back when I have been injured, I see a few little blips of me complaining about "tight hamstring" or "calves disturbingly tight" about 2 weeks before the shin splints took hold.

For me a knot or two generally form on the inside (posterior) of the lower leg under the tibia bone.  It gets tighter and tighter until all of a sudden it's a significant problem. It might feel like the bone is "broken" thats for good reason, the bone itself is swelling from the pressure of tearing the meat off of it. 

Some informal definitions: 
Stress reactions -> when it feels like you have a broken leg and you sometimes fall/stumble from the pain while walking wearing street clothes.  If the bone is painful to touch (especially after activity) this can become a dangerous situation if left unattended.

Stress fractures -> stress reactions that get out of control then show up on the x-ray as little cracks (when I'm reaching for a cane/crutch, this has usually resulted in my doctor telling me to shut down as I've got stress fractures)

Treatments that have worked for me:

I am a huge fan of massage for shin splints, 3x a week for 15 minutes straight (use a timer, time slows down when doing massage)

then I do 15 minutes of modalities... ice, stim, etc.  (I tend to not do any heat therapy)

Massage technique depends on anterior or posterior, i have suffered from posterior pain and the knots get pretty extreme.  Toning down the intensity of the running is critical, but stopping entirely seems to make no difference for me and stopping seems to prolong my recovery. 2 of my last 5 seasons have been very tough with the shin splints.  In those cases, I just cut speed work and brought the long runs down to <2/3 normal long run distance.
  • Here's a decent massage technique for posterior shin splint (find the knot, work it out).  I recommend finding a pro that does it well though and learning from them.
  • https://www.youtube.com/watch?v=HRhvxOAkIKw
For me, shin splints are the symptom of other stuff going wrong, like ultra tight calves or hamstrings.  You need to find your root cause (95% chance its in the calves or hamstrings, hips or all three)  For me, the hamstrings are the root cause of my plantar/shin splints.

Meb's exercises in this video are a staple for me and have kept recent years less riddled with injury.  http://running.competitor.com/2013/07/training/video-stretching-exercises-with-meb-keflezighi_77915

If you are having pain or are in recovery, Ibuprofin and ICE immediately after a run.

My #1 advice: Get real ice packs, use them ever single day!

The seasons I have had bad shin splints, I've needed to ice after every single run for 3-5 months.  

DO NOT HESTITATE, BUY THESE! --- not cheap, but much cheaper than physical therapy sessions and you're going to need 100s of "massage/modality sessions" in your life, so just bite the bullet and do the icing right.

2x Patterson Medical 11x14 cold packs --- i generally ice both shins at once...

Chattanooga Nylatex Wraps (2.5" x 36" for shins is great)

My Therapist uses this, I think it works very well. Biotone Massage Creme

Ice Ice Baby!