Shin splints treatment plan
Our treatment plan strengthens your foot and ankle muscles, core, and the rest of your leg, which helps reduce the load on your painful shin.
Research-based treatment plan
Research shows that the most effective exercise-based treatment plan for shin splints should include exercises to improve ankle and hip muscle strength and control.
Why the hips? If your hip stabilizing muscles are weak, your leg can turn in too much when you run, and this increases the strain on your inner shin.
Finding these types of exercises on the internet is easy. But, do you know when, how, or how often to do them exactly?
The Exakt Health app provides these answers
- The app guides you safely from when your shin first becomes painful to a full return to sport.
- The shin splints treatment plan contains evidence-based exercises with clear guidance on reps, sets, and frequency.
- The app adapts the program according to your feedback and specific needs.
- It implements a walk/run program for a safe return to running.
- We’ve also included a maintenance program to prevent your shin pain from recurring.
The app teaches you about shin splints
Knowing what caused your shin splints, how the healing process works, and when it’s better to see a doctor will help you plan your recovery more effectively and prevent re-injury.
The most common symptoms include:
- Pain along the inner border of your shin bone, spanning an area of about 10cm or more when you press on it.
- It may initially hurt during exercise only, but it can be painful after exercise or while walking or doing daily activities as the injury progresses.
- It usually doesn’t hurt when you’re resting, and the pain doesn’t wake you up at night.
- Often downhill running hurts more than running on flat or hilly surfaces.
- Your leg hurts when you’re lying down, or you have night pain keeping you awake or interrupting your sleep. If this is the case, it could mean that you have a stress fracture.
- Any part of your leg (including your thigh, calf, or foot) is swollen, red, hot to touch, or throbs with pain. It can indicate that a blood clot has formed, and you should investigate it as soon as possible.
- You feel pins and needles or tingling in your leg, which may indicate an injured nerve. In which case, our treatment plan may not be suitable for you.
- Your symptoms worsen.
- Your injury is not healing as anticipated (see expected healing times next).
Overload is the primary cause, but it can also occur due to:
- Muscle weakness or lack of control around the hips and pelvis, causing your leg to turn in more when you run
- Muscle weakness or lack of control in your ankle and foot, forcing you to over-pronate
- Sudden changes in training load like increasing your running volumes too quickly or doing too much downhill running
- Unsupportive shoes that don’t resist over-pronation
- Training on hard surfaces like Astroturf
Run/walk plan
You’re now ready to start a return to running program. The safest way to ease back into running is following a program that alternates between short running and walking intervals.
Use these sessions to focus on your running form, trying not to rush your progress. If you do not feel completely comfortable in a session, it’s always better to stay on that level and repeat the same session next time. Please do this until it feels that you can complete it 100% satisfactorily.
Workouts
The focus in your strength sessions will shift to maintenance, and their frequency will reduce as you run more, helping you prevent overloading your shins.
Treatment
The right combination of rest and exercise, tailored to the individual, is the most effective intervention for shin splints. The best treatment program includes:
- Load reduction: Meaning you reduce your activities to pain-free levels, allowing your injury to settle and recover. For example, you may need to switch running out for cycling or swimming.
- Strength, balance, and control training for your core and other leg muscles early, started early on in your rehab. It can improve your movement patterns and off-load the injured area.
- Foot and ankle strengthening exercises only once your initial injury has settled.
- Calf stretches only once your injury has adequately settled. Stretching sensitive tissues will only agitate them more.
Other treatments that you may encounter:
- Complete rest can be helpful to calm your pain at first. However, it’s best not to rest for a prolonged period because it will weaken your muscles even further.
- Massage can help to make your pain feel better, but it does not strengthen the injured area.
- Electrotherapy is currently not recommended.
- Supportive insoles that reduce pronation may be of use if you over-pronate.
- Shockwave may be helpful in cases not responding to exercise therapy.
Healing times
The length of your recovery will depend on how long you waited before starting the correct treatment plan. Estimated healing times are as follows:
- If your symptoms began less than 4 weeks ago, your recovery could take 12 to 16-weeks
- If you’ve had for 4 to 12 weeks, your recovery could take 6 months
- If you’ve had symptoms for longer than 3 months, your recovery could take 6 months or longer
Prevention
- Do strength training twice a week. The stronger your core and leg muscles are, the less strain there will be on your lower leg.
- Include balance exercises into your training program. They help improve your movement patterns and control.
- Allow enough recovery time between heavy training sessions.
- Avoid significant increases in training volume or intensity.
- Make sure that you get enough sleep and if you feel tired, adapt your training intensity accordingly. You are more vulnerable to injury when you’re physically or mentally fatigued.
The shin splints treatment plan consists of 7 stages
The workout intensities have to increase as your injury heals to regain your full strength. The app helps you progress correctly by setting clear targets at each stage.
Workouts
This stage aims to allow your injury to settle while you start building the base strength and control you need around your ankles, hips, and core.
The app chooses exercises done in positions that minimize the load on the painful area (in sitting and lying).
General advice
The app contains reading activities that teach you to gauge your appropriate exercise level. It also provides cross-training recommendations to help maintain your fitness in the long term.
Activities to avoid
- Strong calf stretches
- Running
- Jumping or hopping
When to progress
You can progress to the next stage when:
- You can complete the foot/ankle workouts without pain,
- and pass the heel raise test the app sets you.
Workouts
It’s now time to start building strength in the muscles that directly attach to the injured area (your calf muscles).
During this stage, it’s still essential to avoid intense calf stretches, as stretching painful tissue will only aggravate it further. For this reason, the app will suggest calf strengthening exercises that limit the amount of stretch in that area. For example, the heel raises to floor level instead of over the side of a step.
You’ll continue to work on core and leg strength, but in positions that place a bit more load through your shin.
Activities to avoid
- Strong calf stretches
- Running
- Hopping and jumping
When to progress
You can move more on to the next stage when:
- You can walk for short distances,
- and complete the calf strength workouts without pain(during or after).
Workouts
Your recovery should be progressed enough for you to start introducing exercises that stretch the tissue that attaches to that area of the shin. The app will choose your activities with this in mind and increase the intensity by adding heavier weights.
When we run, forces up to 6 times our body weight go through our lower legs. For this reason, it’s essential not only to match our body weight but to do heavy strength training too.
Activities to avoid
- Prolonged, strong calf stretches
- Running
- Jumping and hopping
When to progress
You can progress to the next stage when:
- You can walk 30 minutes at an easy pace,
- and complete the calf strength workouts using weights equal to 10% of your body weight,
- and do the hop tests the app sets you without increased pain.
Workouts
This stage will prepare your calves and shin for a safe return to running. The app will introduce plyometric exercises (like hopping and jumping) that mimic the explosive forces created when running to help with this.
You will also continue working on your core and leg strength, control, and flexibility.
Activities to avoid
Avoid all running activities.
When to progress
You can progress to the next level when:
- You can walk at a brisk pace for 30 minutes,
- and can do the full plyometric (hopping) workout without pain.
Run/walk plan
You’re ready to start a return to running program now. The safest way to ease back into running is following a program that alternates short running and walking intervals. Use these sessions to focus on your running form and try not to rush your progress.
If you do not feel completely comfortable with how a session went, it’s always better to stay on that level and repeat the session next time. Please do this as many times as you need until it feels that you can complete it 100% satisfactorily.
Workouts
The focus in your strength sessions will shift to maintenance and their frequency will reduce as you run more, helping you prevent overloading your shins.
Activities to avoid
You should not attempt high-intensity running sessions yet, including tempo runs, interval training, or hill sessions.
When to progress
Move on to the next stage, when you can jog for 20 minutes at a pace that’s easy for you.
Running
The focus is now on regaining your previous running endurance in your calves and other leg muscles. Therefore, you can slowly increase your weekly running volumes.
Researchers suggest that the best way to prevent injury is not to increase your weekly running volumes by more than 10% per week.
Workouts
The strength workouts will maintain the strength you’ve built in the previous stages.
Activities to avoid
Avoid high-intensity running such as tempos, sprints, or hill sessions. Your legs need to get used to your regular slow running volume first.
When to progress
You can progress to the next stage when you’re able to run your average weekly running volume at your regular leisurely running pace, pain-free.
Running
Start training with increasing speed and intensity now. Usually, it’s best to do this incrementally. Start by adding only one session to your weekly schedule.
Workouts
It would help if you continued your weekly strength routine to support your running activities and reduce re-injury risk. The app provides a maintenance program to help keep you on track with this.
Recover faster. Now.
Download the App now and start the recovery with your tailored treatment plan. Adjusted to your specific needs.
References
- Capt Christopher J. Couture & Kristine A. Karlson (2002) Tibial Stress Injuries, The Physician and Sportsmedicine, 30:6, 29-36, DOI: 10.3810/psm.2002.06.337
- Galbraith, R. Michael; Lavallee, Mark E. (7 October 2009). “Medial tibial stress syndrome: conservative treatment options”. Current Reviews in Musculoskeletal Medicine. 2 (3): 127–133. doi:10.1007/s12178-009-9055-6. ISSN 1935-973X. PMC 2848339. PMID 19809896.
- Hamstra-Wright KL, Bliven KCH, Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. British Journal of Sports Medicine 2015;49:362-369.
- Lohrer H, Malliaropoulos N, Korakakis V, Padhiar N. Exercise-induced leg pain in athletes: diagnostic, assessment, and management strategies. Phys Sportsmed. 2019 Feb;47(1):47-59. doi: 10.1080/00913847.2018.1537861. Epub 2018 Nov 5. PMID: 30345867
- Lopes, A.D., Hespanhol, L.C., Yeung, S.S. et al. What are the Main Running-Related Musculoskeletal Injuries?. Sports Med 42, 891–905 (2012). https://doi.org/10.1007/BF03262301
- Patel, Deepak S.; Roth, Matt; Kapil, Neha (2011). “Stress fractures: diagnosis, treatment, and prevention” (PDF). American Family Physician. 83 (1): 39–46. PMID 21888126. S2CID 1736230. Archived from the original (PDF) on 12 February 2019.
