Treating shin splints at the source

I have horrible shin splints that make aerobic activities such as walking and running incredibly painful. Is there any warm-up I can do that might ease the pain?

CJ

West Hollywood

“Shin splints” is a generic term for pain that emanates from the shin or more specifically the tibia, that large bone that extends from the knee to the ankle. They are a common ailment of walkers and runners and can also affect people who play basketball, tennis and volleyball. A suitable warm-up is just one part of treating them. Shin pain problems generally stem from the fact that bodies -- particularly lower bodies -- are imperfect. Flat feet, knocked knees, bowed legs and high arches all can create imbalances and stresses that become exacerbated when someone’s moving, says Dr. Phillip Kwong, a foot and ankle surgeon with Kerlan-Jobe Orthopaedic clinics in Los Angeles and Anaheim. When you’re walking, for example, you increase your load to 1 1/2 times your body weight; running puts it at 2 to 2 1/2 times your body weight. If bones and joints aren’t properly aligned, the extra stress can’t be adequately absorbed by the foot and ankle and it heads north. “So your shin and all the musculature around it, is going to take more load,” Kwong says.

And that can mean pain.

Icing and over-the-counter pain relievers can help, but they’re only temporary and don’t really solve the problem. First, Kwong recommends doing some basic recon on your feet.

Got flat feet? You might need an orthotic that gives more support on the instep, preventing the feet from over-pronating, or rolling in too much.

High-arches? That foot shape is usually less flexible, Kwong says, making shin splints more likely. “When the foot lands, there isn’t the elasticity of the tissue or the mobility in the joints to go side to side, so everything goes up the leg,” he says. Your feet will benefit from more cushioning, via shoes with more padding or an orthotic.

Stretching before and after you exercise will help the muscles move and be more flexible.

Physical therapist Robert Forster, owner of Forster Physical Therapy and Phase IV Scientific Health and Performance Center in Santa Monica, suggests the standard runner’s stretch: Lean forward, with your hands against a wall, keeping heels and toes forward and aligned. Lean until you feel a stretch in your calf muscles.

For a more advanced stretch, stay in that position but move about 6 inches closer to the wall and bend one knee -- you should feel this in the lower part of your shin and your Achilles heel. (You can see images of these exercises at www.medicinenet.com/script/main/art.asp?articlekey=10240.)Kwong and Forster also urge investing in new shoes if yours are old and worn. Often, people don’t notice when soles have ground down and shoes have lost much of their cushioning.

Finally, “Don’t run with pain,” Forster says. “Take precautions, rest for a week or so, or do other activities such as riding the bike.”

-- Jeannine Stein