I have a number of clients who get shin soreness (pain along their tibia) after they are about 20 minutes into a workout. At no time do they have this soreness while they are performing their everyday routine. As I understand it, shin splints go away as your muscles warm up. Are they suffering from shin splints or could their shoes be inappropriate?
Specific questions must be asked when trying to answer your question. What are your clients doing when the shin soreness occurs? Are they walking on a steep incline, running, doing aerobics, jumping rope? Have they changed their training surface from grass to cement? Are they in poor or good health? Do there shoes have flat soles or a raised heal? How many days a week and minutes per session do they train? What area is the soreness in, and does it stay localized or spread over the area? After these questions are answered we can then begin trouble shooting. I will presume they are in good health and you are motivating them to train moderately hard three days a week. With this in mind, we have a few possible choices:
- Shin splints, as you suggested. There are many forms of shin splints. The most common form creates a tearing away of the connective tissues (osseous membrane) from the frontal borders of the shin bone (tibia). This could be the problem. However, it is unlikely that all clients would exhibit the same symptoms and they usually hurt most of the time when training.
- Exercise Induced Compartment Syndrome (EICS). This is usually seen in people who run extensively. If EICS is not corrected, injury can result. The lower leg has four compartments: anterior, deep posterior, superficial posterior and lateral compartments. The anterior and deep posterior areas are most commonly affected. The syndrome occurs when tissue fluid pressure increases in one of these compartments placing abnormal stress on the connective tissues, bone, muscles, blood vessels and nerves. Symptoms are pressure, pain, weakness in the lower leg and problems with flexion and extension of the foot. If these things are occurring, a trip to the physician would be a safe suggestion.
- Overuse injury. There is nothing more common than overuse injuries. Too much too soon in motivated clients can create more aches and pain than they usually have. With a reduction in the training load and following the normal routes for recovery, this problem will usually resolve itself.
- Control inflammation. Suggest the use of non-steroidal anti-inflammatory drugs (NSAIDs) after training. Rub some topical analgesic cream (sports cream) on the affected area before training. Also, an ice massage works very well for cooling the deep tissues in any part of the body and can be used before and after training.
- Control tissue abuse. Try not to over train or over extend your clients to often. A good warm up and stretching of the lower leg and ankle will decrease sudden extertional impact on the tissues.
- Training the lower limb with the tilt board, one and two legs, heel-toe walking and walking backwards should be a good addition to the other exercises you have them doing.
- Arnheim,D. (1987) Essentials of Athletic Training. Mosby College Printing.
- O?Connor,F. et al. (1997) Managing Overuse Injuries: A Systematic Approach. The Physician and Sports Medicine vol.25, no.5, May.