Shin pain SUCKS. Can I get an amen? You get your act together to take advantage of the nice summery weather with some outdoor jogging, even get your gait analysed and invest in some snazzy new running shoes, go on a measly 2 mile run and BAM! The next day you’re greeted with a sharp pain in your shins that makes walking up the stairs at work an interesting manoeuvre! Hmph.
My immediate reaction to this pain was to think: shins splints. Shin splints is the only description for acute lower leg pain I’ve come across, but I’ve never actually thought to delve any deeper into what the heck this even means. The NHS website says that shin splints is “a general term used to describe exercise-induced pain in the front of the lower legs, or shins.” So far, so vague. It goes on to say that the most common cause of shin splints is medial tibial stress syndrome (MTSS). MTSS is thought to occur “when the layer of connective tissue covering the surface of the shin bone (periosteum) becomes inflamed.”
So that’s one explanation, and it does pretty well describe the pain I’m experiencing. But what else could it be? Well, some people think that MTSS isn’t actually that common, and that lot’s of people misdiagnose their shin pain (but a lot of doctor’s obviously think differently, so who knows). Other conditions that could be to blame for shin pain include tibialis anterior tendonitis (inflammation of the tendon which goes down the big-toe side of your shin/ankle*) or a tibial stress fracture (a crack that does not go completely through the bone). Both tendonitis and stress fractures commonly occur in the tibia (shin bone), apparently, and can be a likely cause of shin pain.
Unfortunately for a sports novice trying to figure out a new pain, the causes of MTSS, tibialis anterior tendonitis and tibial stress fractures are all frustratingly similar:
- doing too much too soon
- wearing crappy or unsuitable footwear
- running on hard surfaces or slopes
I thought I’d done my best to avoid shin injury by buying some proper running shoes and keeping my runs to a short 2 mile, but I do run mainly on hard paths and my route includes some slopes. Plussss I maybe ran two days in a row even though I had a little bit of pain after the first day. I know, I know, I’m an idiot.
Reading up on the symptoms of these three conditions isn’t making things any clearer for me either…
Shin Splints (MTSS)
The pain is felt along the shin bone (tibia), which runs down the inner part of your shin. At first you will feel a dull, aching pain. If you ignore it and continue to exercise, it can become very painful and you may have to stop exercising altogether. (source)
Tibialis Anterior Tendonitis
Patients with tibialis anterior tendonitis usually experience pain at the front of the shin, ankle or foot during activities which place large amounts of stress on the tibialis anterior tendon (or after these activities with rest, especially upon waking in the morning). These activities may include walking or running excessively (especially up or down hills or on hard or uneven surfaces), kicking an object with toes pointed (e.g. a football), wearing excessively tight shoes or kneeling. The pain associated with this condition tends to be of gradual onset which progressively worsens over weeks or months with continuation of aggravating activities. Patients with this condition may also experience pain on firmly touching the tibialis anterior tendon. (source)
Tibial Stress Fracture
The most common site of a stress fracture in the lower body is the tibia or shin bone, followed by the metatarsals, the bones in the foot behind the toes. Most stress fractures develop gradually. A typical tibial stress fracture will initially be felt as “shin splints,” a catch-all term that refers to pain along the inside of the tibia. The pain usually starts out over a large area along the shin bone, and is mainly noticed after a hard training session or race, or the morning after a long or difficult workout. (source)
So…. yeah. I am still none the wiser. My shin pain is worse in one leg (which makes me worry it’s a stress fracture or tendonitis), BUT saying that it’s also the leg that I tend to do a funny turn-out thing with when I run/walk (yeah, smooth I aint). I could probably run on it now if I wanted, but the pain is present a few days after I last ran and feels ‘tight’ when I walk down stairs (to the extent that I have a tiny limp). Unfortunately none of my reading about causes of shin pain has helped me to pin point exactly what’s going on, but fortunately treatment for shin pain is similar across the board:
- Ice the area for short periods of time for a few days (my cake-transporter cool packs came in handy!)
- Stop doing the exercise that’s causing the pain (from 2 weeks for MTSS, up to 6 weeks for stress fractures – argh!)
- Choose non-impact exercises that don’t cause pain (e.g. swimming, elliptical training)
- When back to running, avoid slopes and hard surfaces and wear the right footwear
So, no more nice, sunny, FREE outdoor runs for me for a few weeks. Luckily I’ve never experienced shin pain from skating, so I’m going to continue with on-skates practice unless it starts to hurt. Assuming the pain goes away in the next two weeks, I’m going to tweak my running route so that I run on the edge of a grassy field rather than on the hard path that goes around the perimeter, which I’m hoping will help. Other than that I’m not sure what else I can change… Fingers crossed that I don’t just have a terribly funny run which will bugger up my shin no matter what I do!
Any first-hand experience of shin pain? Did you figure out the culprit?
*Friendly word of advice: DO NOT Google image search ‘tibialis anterior tendon’ unless you want to see some truly gut-churning photos of the inside of people’s legs. Seriously.