Running in a Pandemic: The Basics on Shin Pain

Running in a Pandemic: The Basics on Shin Pain

As we are stuck home during the global pandemic and the weather here in Maryland starts to improve for those looking to get out of the house and be active, running is a great option. However, shin pain is a common problem seen in runners whether they are increasing their training volume, getting back into running, or just getting started.  Three primary concerns with shin pain in runners are shin splints, stress fractures, and exertional compartment syndrome. 

Shin splints are a quite common problem and account for 12-18% of all reported running injuries. Shin splints are characterized by diffuse pain along the shin bone (tibia) that is noted with activity, often worsening as running progresses. A key component is that the pain is diffuse rather than localized to a specific location.  Oftentimes continuing to run with shin splints that are untreated will result in pain that starts sooner during activity and when the activity is less intense. The cause of the pain is more likely to be irritation of the lining of the bone (called the periosteum) along the shin as well as tendinitis of muscles that originate along the bone. 

Stress fractures of the shin bone (tibial stress fractures) are another relatively common problem in runners.  This is a bit of a different issue as it is from overuse where the bone itself is unable to adapt to repeated stress.  While stress fractures are usually thought of as an injury in distance runners, they can occur in any person who has had a significant change in their running habits such as running more often or for longer distances.  Symptoms are primarily pain that is localized to one spot on the shin bone.  The pain is certainly worse with running and may get to the point where it is even painful with walking. 

A less common cause of shin pain that we are going to talk about is exertional compartment syndrome. Exertional compartment syndrome is a problem with swelling of the muscles in the lower leg during activity leading to increased pressure in the compartments housing the muscles.  This is primarily noted as calf pain and tightness associated with activity that will gradually resolve within minutes of stopping the activity.  This may be associated with numbness in the leg or into the foot.

This begs the question of what should be done to prevent shin pain and to treat shin pain if it does become a problem with running.  Prevention starts with the use of good shoes to help support the foot and arch.  Additionally, changes in an exercise program should be gradual and deliberate; slowly working up to the desired goal.  Finally, adequate nutrition is key to providing appropriate fuel for training and should not be overlooked.  If you do develop shin pain begin relative rest and the use of anti-inflammatories as well as ice for treatment.  If these are not successful or you are unable to return to running, a sports medicine professional is always able to help you with a diagnosis and begin treatment to get you back to running.

Author: Dr. Matthew Jepson, M.D.,CAQ-SM

The Centers For Advanced Orthopaedics- MMI Division is here to help. Our experts in Sports Medicine provide exceptional care close to home, saving you the time and expense of the hospital systems. Let us help you maximize your performance today. Telemedicine and same day in office appointments always available. Visit mmidocs.com.