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Dr. J. on Running

Shin Splints

Preventable Injury

Published October 30, 2000 in The Post-Standard.

By Dr Kamal Jabbour, Contributing Writer

She ran in visible pain, with both legs wrapped in ice bags. She appeared to be in her late teens, possibly a high school student, probably a college harrier, out for a training run in the middle of the afternoon. Her face grimaced with pain with every step, as my blood boiled in anger.

Wrapping ice bags atop the shins and running in pain are symptomatic of shin splints and irresponsible coaching. I may have jumped to a hasty conclusion blaming an overzealous coach, but I am hard-pressed to believe that a recreational runner would wrap her own shins just to go out for a fun run.

Besides, the timing was beyond circumstantial. A few days later, the cross country season would end with collegiate and scholastic championships. Was a coach trying to get one more good performance out of a star runner?

Shin splints are caused by an inflammation of the sheath that connects the calf muscle to the tibia. They commonly occur among beginners, and result from running too much too soon. Among seasonal runners who rest during the summer, a return to fall running is a common culprit for shin splints.

In experienced athletes, a sudden change in training intensity or volume can trigger shin splints. Similarly, a move from the soft trails of summer onto the hard concrete of indoor tracks can create problems. Finally, the demise of shoe insoles or coaching commonsense can also cause shin splints.

Adding guilt to pain, athletes suffering from shin splints often become convinced that they must run through their injury. They turn to painkillers and anti-inflammatory drugs to mask the symptoms. As the sheath detaches further, and reduces soft tissue protection for the bone, stress fractures and broken bones can result.

Experts agree that shin splints can be prevented. Running year-round, even at reduced levels in the off-season, maintains calf flexibility and shin health. A gradual increase in running volume at the start of the racing season and a cautious escalation of training intensity for early competition can provide an ounce of prevention that is worth more than a ton of treatment.

By the same token, runners must replace their running shoes at the start of every season. Ideally, a runner should rotate between two pairs of shoes, a newer pair and an older pair, to even out the imperfections in shoe fabrication and bio-mechanical imbalance.

At the onset of shin splints, rest is the only safe course of action. Icing the afflicted area and ingesting Ibuprofen may speed-up healing, yet resting the legs from the daily pounding is the surest way to their healing.

My conservative approach to injury prevention and treatment among young runners stems from my belief that running is a lifelong endeavor. Few children enjoy running in pain, if it were not for peer pressure and team loyalty. I hold the parents and coaches accountable for the well-being of our children by responding to early signs of injury with encouragement and support, not just ice bags and drugs.

Kamal Jabbour runs and writes on the hills of Pompey, New York. His RUNNING Column appears in The Post-Standard on Mondays. Dr.J. created TrackMeets.com, webcasting live Every Lap of Every Race. He receives email at jabbour@syr.edu.


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