PT Corner: Exercises Designed To Prevent Shin Splints.
A few years ago while training for the Boston Marathon, I developed shin splints. I thought if I could just make it through the race I would then do everything I could to rid myself of shin splints, and prevent myself from getting them again. I finished the race with lots of help from homeopathic remedies and stretching at varying intervals, and then it was on to rectifying the situation. Below are some possible causes and ways to address them. Here is a list of some common causes for shin splints with an emphasis on people who are experiencing them as runners or walkers, as well as some ideas to address them:
What shoes you wear is a personal preference with both style and mechanics. Some people prefer barefoot style with low profile shoes, while others need more shock absorption to offset forces to the lower body. In any case, turn over your shoes and take a look at how the soles of your shoes are wearing thin. Do you see one side of your heel thinner than the other? Compare your shoes that you walk, run or exercise in and see if there are differences in pattern. This discovery is not a diagnosis of a foot pattern, but insight as to how you might be weight-bearing in your everyday activities, and what exercises and/or supplemental support (like orthotics or insoles) may help you. Because walking and running are different biomechanics, it is recommended to have different shoes for these activities.
2. Walking/running route and training
Walking or running the same route day after day? Then the body undergoes the same stress and muscles and joints can experience overuse. Changing directions, inclines, and terrain can help work different muscles and joints. Add variations within your runs or walks. If running, pick up the tempo, change stride lengths, focus on form, not that you are not already thinking of form but some of us might just tune out to an audiobook or music. If walking, consider similar aspects like stride length, full heel strike to push off through the big toe, connect with posture and note core activation and shoulders pulling away from the ears.
3. Muscular imbalance of the entire lower extremity and core
A common tendency amongst cardio enthusiasts is to avoid strengthening, or stick to the same exercises without adding any variations. As a therapist, I will create 2-3 routines with different exercises and tweaks to challenge the body in varying ways. Rather than being overwhelmed with having to learn new exercises, perform the same exercises with varying tweaks. For instance, squats can be done with the feet narrow, medium and wide widths with the feet parallel and staggered. Side squats are typically performed with the heel at the lower corner of the squat stand. For a variation, bring the foot to the midline of the squat stand with the heel lifted. Calf raises on the squat stand or toe bar are typically done with toes pointed forward. A “tweak” may be turning the toes inward or outward. With lunges incorporate reaching forward, overhead to the side, and/or rotate to varying sides. With planks with the glideboard closed add arm leg reaches forward, side, and rotational.
New exercises might include hip hinges to teeter totters, ankle sways/ski jumper, curtsey lunges, monster walks, and sprinter start.
The core is mentioned here, as strength and stability in the trunk is needed provide a stable base for the lower extremity to work off of. The essence of Total Gym is that each exercise challenges dynamically as in pullover crunches or statically as in chest press. However, if you move mindlessly through the workout, then the effectiveness is lost.
- Squat Tweaks
- Side squats with foot middle of squat stand
- Calf raises with legs IR/ER
- Lunges with reaches
- Plank with upper and/or lower body reaches
4. Muscular tightness
Stretching is key to muscular strength and power. When time is shortened, one’s stretching routine tends to shorten as well. Commit to yourself to dedicate 2-3 times/week for 15-20 minutes to stretching. Since our bodies tend to move in three planes of motion, forward and back, side to side, and rotational, add these directions into your stretching. For instance, hamstring stretching by long sitting with the feet on the squat stand or base reach forward, to the right and to the left, feel the different areas of the calf stretched. In a runner’s lunge position with hands on the wall or glideboard facing the tower, step one foot forward, to the right and left then rotate the hip right and left. Use the arm pulleys to help deepen an outer hip stretch. Facing the tower, sit toward the lower one third edge of the glideboard with the arm pulleys in each hand. Bend one leg and rest it on the glideboard, similar to the position the figure four position of crossing an ankle over the opposite knee. Allow the arm cables to pull you forward and feel the stretch in the hip whose leg is on the glideboard. The stretches I love to end with are those using the leg pulleys. Whether you are scissoring or making circles, the leg pulleys allow for you to stretch in a manner different than that on the floor.
- Hamstring stretches with long sitting rotating trunk
- Runners lunge/single thigh stretch with reaching forward, side, rotational
- Outer hip facing squat stand with pulleys legs in figure 4
- Leg pulleys
5. Walking and running mechanics
Walking mechanics involve the foot striking from the heel to the big toe push off, with the hips and trunk responding accordingly. In a quick overview, when the foot hit the ground the lower leg rotates inward, which in turn activates the hip muscles, to control the inward rotation and assist with push off. When there is a weakness anywhere from the foot to the hip, then strain can occur including shin splints.
- Janda short foot
- Demonstrate the chain reactions of the foot when walking and IR chain reaction counteracted by hip ER.
- Demonstrate compensation with hip jetting laterally with single leg stance
- Curtsey lunges
- Monster walks
- Side planks
6. Injury such as a stress fracture
Undetected fractures or injuries can lead to surrounding muscles to spasm to protect the area or alter biomechanics leading to undo stress to varying muscles. Thus, it is always recommended to seek medical help with experiencing pain which is getting worse, not relieved with rest or ice, and continues to linger even if pain is not increasing.