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The Doctors Book of Home Remedies II: Shin Splints

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Shin Splints

They sound like something you'd strap on your legs to keep them from going wobbly in midmarathon. But if you're a runner worth your neon green, light-as-a-feather jogging togs, you know the truth: Shin splints cause searing lower leg pain that you can definitely do without.

Of course, you don't have to have wings on your feet to suffer from shin splints. Just plain walking, especially on hills or uneven surfaces, or wearing the wrong kind of shoes can cause them. And it can happen to anyone any time he puts his underused muscles to work. The connective sheath attached to the muscles and bone of the lower leg becomes irritated, resulting in a razorsharp pain in the lower leg along the side of the shin bone.

"The pain is your body's way of saying you've had enough," says sports injuries specialist Craig Hersh, M.D., of the Sports Medicine Center in Fort Lee, New Jersey. "If you ignore the pain and don't let up on the activity, it could result in a stress fracture. It's like bending a piece of metal back and forth over and over again--eventually it breaks."

To speed healing--or dodge shin splints entirely--work these home remedies into your workout.

Put ice on your shin. You can soothe sore shins by rubbing them for 20 minutes with ice that's been frozen in a paper cup, says Dr. Hersh. Or fill an empty bread bag with ice, wrap it in a towel, and strap the bag to the front of your shin with an elastic bandage for 20 to 30 minutes, says James M. Lynch, M.D., team physician for Pennsylvania State University in University Park. If you apply ice quickly, it reduces inflammation and eases pain, says Dr. Lynch.

Mix in massage. Although a shin massage may not produce long-term benefits, you might feel at least temporary relief, says Dr. Lynch. The best approach: gently stroking the top of the lower leg with your thumbs for 15 to 20 minutes.

Pamper with a pain reliever. Any number of over-the-counter medications such as Advil and Nuprin contain the ingredient ibuprofen, which helps take the edge off pain, says Dr. Lynch. But aspirin and acetaminophen (Tylenol) are also effective painkillers, he says. (Do not give aspirin to children because of the risk of Reye's syndrome.)

Give it a rest. But instead of sitting on the sidelines until all your symptoms have subsided, try an alternative activity, says Dr. Lynch. "I don't believe in pure rest," he says. "But if running is the offending activity, then I'd reduce that and switch to biking or swimming. Then work your way back slowly. When you're sure you're getting better, start running again."

Make a change for the familiar. What's the number one cause of shin splints among U.S. Olympic hopefuls? Change, according to Jennifer Stone, head athletic trainer at the U.S. Olympic Training Center in Colorado Springs, Colorado.

"Lower leg pain is generally caused by change, and that can be change in almost anything--your shoes, your training program, even the surface you run on," says Stone. Examine your training program--did the pain follow a change? If so, you're better switching back to the familiar routine--at least for now, she says.

See if you're a P or an S. Because the way you run has a lot to do with how your shins feel, do some simple tests to determine whether you pronate or supinate.

Overpronators roll their ankles and feet inward while they run, inequitably transferring much of the pounding into the inner portion of their lower legs, says Paul Raether, M.D., a marathoner who is a physical medicine specialist at the Kaiser Permanente Medical Center in Portland, Oregon. Supinators, however, don't turn in their ankles when they run, directing damaging stress to the outside of the legs, he says.

One way to determine your footfall tendency: Step into the tub to get your feet wet, then stand on the dry floor and look at your footprints. (To make them easier to see, step on a couple of paper towels.) If you can see your arch, you are an overpronator; if you can't, you are an underpronator (supinator), says Dr. Raether.

Then pick the proper shoes. Choose carefully. "Some shoes on the market offer more control than others," says Stone. "If you pronate, you need what's called a board-lasted shoe." To tell if a shoe is board-lasted, pull out the insole-the extra strip of material that's inside the shoe. If there's no stitching between the insole and the bottom of the shoe, it's board-lasted, just what a pronator wants. If you're a supinator, you need the other kind of shoe: Look for an insole that is stitched or stitched and glued, says Stone.

Grab some low-cost orthotics. Specially molded shoe inserts (orthotics) can often correct pronation, but they can cost a bundle. Here's an inexpensive alternative to try first: For a few dollars, get a pair of shoe inserts from the drugstore and slip them into your running shoes--they may be all you need, says Stone. If your shins are still in rough shape after using a cheap insert, see a podiatrist for the higher-priced model.

Walk before you run. It's always best to warm up the muscles of the lower legs before you go on a run, according to Stone. One way is to ride a stationary bike for ten minutes. Or take a brief walk before you break into a full-paced canter.

Pig out on hamstring stretches. Tight hamstrings--those tendons on the underside of your thighs--can literally knock you off your stride, says Stone. To keep hamstrings loose, she recommends the hurdler's stretch. After warming up, sit on the ground, extend your right leg forward, and place the bottom of your left foot on the inside of your right leg so that you're making a P with your legs. Slowly lean forward, reaching your hands to your right foot and keeping the small of your back down for a count of ten. Switch legs and repeat.

Stretch your Achilles tendons. One of the best ways to avoid shin splints is to stretch the Achilles tendon--the tendon that joins your calf muscles to your heel. Here's how: Stand about three feet away from a wall and lean against it with your hands. Start with your legs shoulder-width apart, then move your right leg forward while keeping your left leg straight. Gently lean toward the wall until you can feel the stretch on the back of your left leg and hold for ten seconds. Repeat with the other leg, says Stone.

Strengthen those shins. Shin pain is often caused by weak lower leg muscles. To build those shin muscles, Stone suggests the following routine: Sit on a table with your legs hanging over the edge. Hook one ankle through the handle of a backpack that has a book in it. Without moving your upper leg, flex your foot upward for two to three seconds. Repeat 10 to 12 times. Then switch feet and repeat. You can also strengthen your lower legs by performing basic lower leg exercises such as drawing each letter of the alphabet with the big toe of each foot in the air.

Give your calves a moving experience. Your calf muscles can use some attention, too: With your shoes off, stand erect. Slowly rise onto your toes and make like a ballerina for a count of three. Lower and repeat 12 to 15 times. If that's too easy an exercise for your calves, you can make it more challenging by performing the same exercise while standing on a step and allowing your calves to stretch over the edge of the step. Be sure to hang on to something, so you don't fall down the stairs.

Save your best stretch for last. Because research shows that your muscles are more elastic after they've been warmed up, a thorough stretch at the end of your workout will help eliminate any shin pain, says Stone. "The best time to work on flexibility problems that can cause shin splints is when you're finished exercising," she says. All exercises for hamstrings, tendons, shins and calves should be done after as well as before you begin your workout.

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