Answer:

Shin splints can be caused by sudden increases in mileage, walking uphill, overtraining, walking faster than normal, jumping, running stairs, or just too much distance. They can occur on the medial, or inside of the shin, or on the lateral, or outside of your shin. Medial shin splints are usually caused by excessive pronation or flat feet, and often by pounding from running, or sports like tennis, volleyball, and other weight-bearing activities. If you have medial shin splints and flat feet or excessive pronation, an orthotic device or over-the-counter arch support like Powerfeet or Spenco can sometimes be helpful. Make sure it's a full-length insert.

Lateral shin splints (sometimes called anterior shin splints) are usually due to overuse and inflammation of the anterior tibialis muscle and the muscle compartment in the front of the leg, along the outside front of your shin. The anterior tibialis muscle flexes your foot upward. People frequently get anterior shin splints from the repetition of flexing the muscle. For instance, on the treadmill, if you walk fast enough, and for long enough, or if you've suddenly increased the speed, or you're walking on an elevation, the muscle gets overworked and starts to cramp. It would be like doing hundreds of biceps curls until your arm started to cramp. Plus, on the treadmill, there's no letup since the mill just keeps going. You could potentially have the same problem if you walked or ran briskly outdoors for a long period of time at a speed faster than you're used to.

Treatment for shin splints includes rest, massage, ice, stretching, and strengthening. Rest and ice is sometimes the best treatment. You should also be stretching your calves and Achilles tendon real well. If you have the problem during running or walking, try warming up more and don't increase the speed too quickly. You can also try varying the speed and elevation of the treadmill if you use one instead of keeping it the same.

To stretch your calves:

1. Lean against a wall with one leg forward and the knee bent.
2. Keep the rear leg straight, heel on the floor.
3. Keep your back straight and lean your hips forward until you feel a stretch in your calf. If you don't feel it too much, put your toe of the rear leg up on a tree limb, or a dumbbell, or any other small object, so that you bend the ankle more. Your heel always remains on the floor. That will increase the stretch.
4. To stretch the soleus muscle and Achilles (very important for shin splints), do the same calf stretch but bend the back knee slightly and you will feel the pull on your Achilles tendon.

When you stretch, make sure to hold the stretch until you feel looser and not just for 10-15 seconds. The point to stretching is to stretch the muscle, so hold it until you feel stretched.

Also make sure your shoes are sturdy and give you lots of support, particularly in the arch. If your shins hurt you should gently massage them and then ice them after you work out.

Published Jan. 26, 2004.