Common Endurance Training Injuries & How PT helps: Shin Splints

Training for an endurance event such as a triathlon or a marathon can be challenging and rewarding, but can often result in injury. There are multiple reasons injury can occur: progressing training too quickly, not allowing enough rest between workouts, muscle imbalance or poor footwear.  A common injury that runners and triathletes experience is shin splints, or tibial stress syndrome.

Tibial stress syndrome is somewhat of a catch-all term for injuries in the front of the lower leg.  Pain can occur along the inside or outside border of the shin bone (tibia) and usually increases with intensity or duration.  Pain often resolves with rest.  However, after a tough workout, aching can persist at rest.  The muscle along the bone is often tender to the touch and can swell.

One cause of this pain can be irritation (either acute or chronic) of the muscles around the shin bone.  If the problem is strictly muscular, it can often be resolved with stretching, appropriate strengthening, modalities such as heat or ice, and massage. Another possibility could be stress fractures along the shaft of the tibial bone.  They are tiny, hairline fractures that sometimes can039#t even been seen with an x-ray.  Similar treatment can be applied but only after long rest periods and wearing a boot or splint. Additionally, a cause can be tightness in the fascia, or outer covering of the muscle, called compartment syndrome.  Symptoms are similar but should be monitored to ensure that the condition is not worsening, in which numbness and weakness can occur.  This condition can be treated conservatively with stretching and massage but surgery could be indicated depending on severity. Check out the video below for a sample stretch that you can do:

As previously mentioned, shin splints can indicate various injuries and it is important to know what the issue is. If pain continues for more than 1-2 weeks then a physical therapist can evaluate and help determine the cause.  From there, the PT can guide you through an appropriate treatment plan, help adjust your footwear, or refer you for further testing in order to safely address the issue and get you back on your feet.  Once it is appropriate to get back into training, it may be beneficial to do so with a group such as Team Philly Race Training. Team Philly consists of trained professionals who help runners at all levels train for various distances, in a safe and controlled manner.  A group may help you reach your goals and avoid re-injury.

Contributed by: Emily Baith, PT, DPT, ART