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REHAB - How to reduce shin pain when running

Just like our KNEE PAIN article, this is a quick “how to” guide to help you reduce and hopefully eliminate the pain associated with “shin splints” as it is commonly referred to. It may not be a long term solution if the causes of the pain are not addressed as well as the source of the pain. Once again, our advice comes from years of client and personal experience with shin pain related to running and jumping. There are many possible reasons for someone to experience shin pain when running or walking. We will in this case, simply look at what we have seen to be the main “version” of so called “Shin Splints”


This article is designed to be very simple in nature to make the understanding process as easy as possible. Please refer to our full article on Shin Splints in the ARTICLES section of the website for a more in depth analysis of the reasons behind shin splints and how to correctly fix them.


Just to clarify, the Shin Splints we are referring to is the pain that occurs in the shin area when running or after running. It will feel like a sharp stabbing pain due to exercise, that may continue as a dull throbbing pain post exercise.


PAIN RELIEF

Short-term strategies for pain relief from shin splints are designed to reduce and eliminate pain and allow for movement/exercise to recommence without pain. Returning to exercise may once again be painful if some of the below Long-term strategies have not been addressed.


Our Long-term strategies focus more on the “why” shin pain is occurring rather than how to immediately reduce pain. They aim to create a solid foundation of strength, stability, flexibility and technique to ensure that shin splints do not occur at all. You can read more in our long version of this article.


For now though, let’s get rid of the pain and try to prevent it happening.


Short-term Strategies

Our main short-term strategies are:

  • Stopping Exercise

  • Rest and Ice

  • Stretching and Foam Rolling/Self Myofascial Release

  • Simple Strengthening Exercises


1) Stopping Exercise


Initial relief from shin splints can be gained by simply stopping the movement that is causing the pain which means stopping the shin muscles having to work so hard in lifting the foot. Stopping the movement/exercise and stretching the calf muscles briefly may assist in allowing the exercise session to continue. Do not return to the exercise or movement that caused the pain until the following steps have been taken.


2) Rest and Ice


Once the exercise has been stopped, applying ice to the front of the shin will help to stop the immediate pain. Some people have even found that wrapping the entire leg with ice packs assists in pain reduction even more than just placing them on the shin.


There is no hard and fast rule with icing, though some do suggest 20 mins on and 20 mins off. We suggest that you work within your own pain tolerance and always separate the skin and the ice pack with some form of sheet or towel to prevent burning of the skin. We do not recommend icing before exercise as the cold will actually make the muscle more susceptible to injury.


Once the pain has reduced, rest the limb for a few days before attempting some stretching/foam rolling.


3) Stretching and Foam Rolling/Self-Moyfascial Release


After the pain in the shins has subsided to acceptable levels then it is time to begin some foam rolling/self myofascial release (See below) of the calf and shin muscles and spend some time stretching out both sets of muscles (See below).


Examples of how to do this are provided below. Aim for 1 or 2 times a day and spend a good few minutes on each set of muscles to get best results.


4) Simple Strengthening Exercises


Much of the pain in the shins can be attributed to a strength imbalance in the lower leg, which leads to many other problems such as technique and load bearing forces. Along with the stretches and foam rolling, complete the simple strengthening exercises below once or twice a day for 1-2 weeks to help create a stronger and more balanced lower leg strength profile.


5) Long-term Strategies


Our Long-term Strategies for reducing and eliminating shin splints expand off the short-term strategies and go deeper to explore the reasons behind why the pain is occurring. These strategies can be found in the full version of this article. They include:

  • Stretching

  • Foam rolling

  • Strengthening

  • Stability of hip/knee

  • Taping/strapping

  • Technique (use of foot/toe, weight distribution)

  • Shoes

  • Training intensity, periodization


TECHNIQUES FOR FOAM ROLLING THE LOWER LEG


Foam rolling is a form of self myofascial release and can be used to remove tightness and sore spots in muscles. Foam rolling is not difficult and can be done be virtually anyone. Below are descriptions and photos of the muscles we suggest you work on to help relieve tight shin and calf muscles. If you are struggling with technique or are not sure what you are doing, please contact us for help.


Peroneals


  • Lie on your side and place the elbow directly underneath the shoulder to support the upper body.

  • Stabilise the shoulder by drawing the shoulder blade “down and back” and not just letting the shoulder joint elevate.

  • Place the roller under the lower leg about half way down the leg and lift the hips off the ground.

  • Engage the core and maintain a neutral control over the spin

  • Start with Holds and Back and Forth movement from the start to just below the knee joint.

  • Small internal and external rotations can be made, however the release then focuses on the gastrocnemius and tibialis anterior respectively.

  • When using the Hold technique, increase the potential release by slowly extending and flexing the leg at the knee.

  • Finish with Long Rolls from just above the side of the ankle to just below the side of the knee joint.


Tibialis Anterior


  • Lie on your side and place the elbow directly underneath the shoulder to support the upper body.

  • Stabilise the shoulder by drawing the shoulder blade “down and back” and not just letting the shoulder joint elevate.

  • Place the roller under the lower leg about half way down the leg and lift the hips off the ground.

  • Engage the core and maintain a neutral control over the spine

  • Start with Holds and Back and Forth movement from the start to just below the knee joint.

  • Small external rotations can be made, however this focuses the release on the gastrocnemius and peroneus longus.

  • When using the Hold technique, increase the potential release by slowly extending and flexing the leg at the knee.

  • Finish with Long Rolls from just above the side of the ankle to just below the side of the knee joint.


Calves (Gastrocnimeus and Soleus)


  • Place the roller under the leg just above the ankle joint.

  • The other leg can be placed on top of the bottom leg to add pressure or placed out to the side or placed alongside the bottom leg on the roller for a duel release.

  • Engage the core, stabilise the shoulders and maintain a neutral control over the spine.

  • Start with Back and Forth rolls just above the ankle and progress to Holds and On/Off up the leg to just below the knee.

  • Make sure to internally and externally rotate the leg to get the medial and lateral aspects of the muscles, particularly in the upper half of the leg in the gastrocnemius region.

  • Finish with Long Rolls from the ankle to below the knee.


TECHNIQUES FOR STRETCHING THE LOWER LEG


Calf - Standing Against a Pole :


  • Place one foot up against the pole with the toes pointing upwards.

  • Place the other foot behind for balance

  • Hold onto the pole and pull the whole body forward whilst also pushing up off the back foot.

  • Keep the hips forward and the upper body upright

On a Set of Stairs :

  • Stand on a stair with one foot only resting on the forefoot and the heel hanging over the edge of the stair.

  • Hold onto a railing or wall for balance.

  • Shift the weight onto the rear foot so that the heel drops as far as possible.

  • Bend the supporting knee to assist.

Child Pose

  • Slowly sit back onto the heels with knees directly underneath hips and feet fully extended in plantar flexion.

  • Lower the head to the floor.

  • Place the arms along the sides of the body and place the hands, palms up, on the lower back.

  • If this posture is stressful to the quadriceps, you may place a rolled up towel directly behind the knees.

  • If the head will not reach the floor, you may place the hands, or fists, underneath the forehead to elevate the head.


TECHNIQUES FOR STRENGTHENING THE LOWER LEG

Heel Balances

  • Stand tall and straight with a neutral spine.

  • Keep the knees slightly bent and lift the toes off the ground

  • Hold for 5-10 seconds before repeating.

  • A finger lightly pressed against a wall or pole may be used to help with balance.


Calf Raises


  • Push the heels off the ground by flexing the calf muscles until you are up on the ball of your feet or even your toes.

  • Hold this position for 5-10 seconds.

  • Variations include holding the flexed position and completing fast “pulses” of movement – not quite letting the heels touch the ground before flexing the calf muscles again to raise the body.

#rehabilitation #shinpain

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