The Great Shin Splint Debate

One of the inevitable things that none of us looks forward to in the spring is the plague of shin splints.  Your athletes are changing surfaces and not a one of them has purchased new shoes.  We've been practicing outside for a week and I'm looking out my office window as I write at four track athletes hanging around my ice bath waiting their turn to ice their shins up.

Over the years, I've encountered a lot of different opinions on what the best way to treat shin splints really is.  We all have our own methods and opinions on it, and tend to settle into a pattern when we find something we think works.  Two years ago I decided that instead of settling on a pattern, I would experiment and see for myself whose way really is the best.  The results of my experiment?  Pretty much everyone's methods work!  Not every treatment will work on every athlete, so it is best to keep your mind open when you encounter some of the sillier ones, because they might surprise you.

• Pre-practice moist heat - I try to avoid this in more acute cases, for obvious reasons.  For an athlete who comes in halfway through the season complaining that he or she has been having a nagging problem with shinsplints all year however, this can be a lifesaver.  The heat will loosen up the anterior tibialis and take pressure off of the insertion where the pain is located.  I find that this is best used in combination with taping or wrapping treatments, and should always be followed up with ice after practice.

• Shin taping - How many of my readers just groaned?  Yes it's an old method, but we're still using it so there has to be something to it.  moving the muscles across the leg with tape takes pressure off of the insertion point where the pain is coming from, relieving the pain.  For some athletes, I've found that this is the only solution.  I can stick arch supports in their shoes until the cows come home, but nothing seems to work for them like a good old tj.  The downside to shin tape is that you may need to get your male athletes to shave their legs.  I've tried this method using underwrap, but it just does not work the same. 

• Neoprene calf sleeves - An interesting spin on several taping methods, calf sleeves work much the same way as a heat treatment does, except their effects last all the way through practice.  Not only do you get the heating effects of a MHP, you also get the compression effects of a tape job.  The downside to neoprene is that it gets extremely sweaty during practices, especially on hot days and needs to be cleaned frequently.  Sleeves run about $10-15 a piece depending on the brand.  If I have them available, I loan out one pair and recommend to the athlete that they purchase a second pair.  This cuts down on the laundry they have to do, and ensures that your athlete will (hopefully) have cleaner gear.

•  Toe tap exercises - I was flabberghasted when I heard about this one, but as a high schooler with terrible shin pain I was ready to try anything.  My athletic trainer recommended that I try an exercise where I just tap my toe on the ground to build up the muscles in my lower legs and relieve some of the pressure on my shins.  Believe it or not, this does actually work for some athletes!  It can be done at any time of the day, so kids will do it while they're doing their homework or sitting in class as something to do.  Keeping the heel on the ground, lift the toes and tap your foot on the ground, that's it.  Use in combination with other treatments.

• Flexiwrap taping  - I know what you're thinking, that stuff is for taping on ice bags, what good is it going to do for shins?  This is another method that it's best to keep an open mind about.  Flexiwrap can be used to take the place of neoprene sleeves if you don't have the funds for them.  It acts the same as the neoprene would, keeping the heat in the muscle while adding a push to keep the pressure off of the muscle insertion.  If you're feeling extra ambitious, you can even put a product like Biofreeze or Cramergesic on the skin before taping for a little extra feeling of heat.  If you're doing this however, make sure to test it on a small area for a practice first - some athletes are more sensitive than others!

•  Arch taping  - This is my current go-to treatment, as it appears my current set of athletes are rather biomechanically unsound in the arch department.  Correcting leg position by adding support to the arches should take the pressure off of the shins and hopefully help prevent other problems further up the leg into the season.  The downside to arch taping is that some people are more sensitive to changes in their feet than others are and athletes might not be willing to try and get used to arch tape if it is uncomfortable.

• Insoles or arch supports - Insoles are expensive, so I tend to wait until I've tried a few other things before recommending their use.  Store bought arch supports will work for some athletes however, so it isn't a bad idea to consider their use if an athlete has feet that can be corrected using a softer insert like the ones found at the drug store.

•  Ice cup massage - If you have a freezer in your training room, you should have a backstock of ice cups waiting to be used.  For shame if you don't.  Slapping an ice bag on the shin doesn't have the same cooling effect as an ice massage does.  You get greater contact time, and the rubbing motion across the muscle and shin area can help to relieve pain too.  

• Ice bath - Seriously, don't put an ice bag on shin splints.  Personally, I love the ice bath.  Sure it takes a little more time out of your day to fill and empty and clean, but the treatment is so much more effective than a simple bag of ice, why not use it?  Don't have a whirlpool or a tub?  Get a party bucket, they're less than ten dollars.

 Good luck this spring everyone, and stay on top of those shin splints!  When left untreated, those shin splints can and will turn into a stress fracture that will end the season.