Treatment Options and Preventative Measures

Shin splints can be prevented. The measures described below are designed to prepare the body for the abnormal stresses associated with vigorous activity.

Warm-Up: All active athletes, regardless of level and type of exercise, should take a few extra minutes to properly warm-up and stretch. Warming-up greatly decreases the chance of straining tendons [2, 4]. The proper way to start exercising is to move the body around to increase blood flow. Move each body part through its entire range of motion that will be required in the exercise for which you are preparing.

Stretching: Once warmed-up, stretching should be initiated. Stretch lightly and hold each stretch for up to 20 seconds without bouncing. To strengthen the area after warming-up, walk around on your heels with yours toes in the air. Without stretching and use, tendons tend to contract and shorten—this increases stress to various parts of the musculoskeletal system—stress we want to avoid. Stretching and warm-downs after activity allow the muscles to eliminate waste products and limit the amount of muscle ache after strenuous exercise.

Proper Shoegear: Runners have a distinct advantage over figure skaters and gymnasts—runners have complete control over their shoegear and can select particular features that will address the mechanism responsible for their shin splints.

Most shoes have a mileage lifespan of 300-350 miles. Many runners will complain of leg cramps, ankle pain, and knee pain when exceeding the recommended shoe mileage. One simple way to test shoe laxity is to grab the shoe in the front and back while twisting in opposite directions. If the arch area twists easily, then stability has been compromised. Compare twisting an old shoe with a new one to gauge the flexibility differences. Note: This twist test only works for running and walking shoes; the additional rigid materials in cross-training and basketball shoes prohibit the twist test from accurately assessing shoe stability.

Orthoses (Shoe Inserts): Orthoses are devices placed in shoes to control abnormal motion. Over-the-counter (OTC) orthoses will physically hold the arch up, thereby relieving some of the troubled tendons’ work. The support of the orthoses should not be felt in the middle of the arch, but should be located closer to the heel. A slow break-in period is recommended when initiating orthoses. The orthoses should be worn as long as tolerable initially (usually 2-3 hours). When they become uncomfortable, remove them. With each successive day, increase the amount of time the devices are worn. Ideally, the orthoses should feel comfortable by the end of two weeks to the point where they can be tolerated for the entire day.

If OTC orthoses offer only mild relief, custom-molded orthoses may be more beneficial. Your foot specialist can prescribe custom-molded orthoses that conform to each foot’s unique shape. These prescribed devices can last upwards of five years, but customizing comes with a price—a $300-400 price tag to be more specific. At about $20-40 a pair, OTC orthoses are a viable option offering varying degrees of success. OTC devices are less durable, need to be replaced more frequently, and because they were designed to fit a population of feet rather than your own, may not fit properly to provide optimal performance. Like shoegear, the symptoms and progression of relief will dictate when the devices need to be replaced.

Note for track runners: Running on tracks with turns can place stress repeatedly on the side of the turns—a simple remedy is to alternate directions around the track from one training session to the next.