View Full Version : On shin splints
CocamoJoe
03-20-2008, 00:14
The demise of my attempted thru-hike last year was a horrible shin-slint in my left leg. It was the most bitter and brutal pain I'd ever experienced. I hiked 460-miles in 34-days, from Springer Mountain to Damascus, VA, from May 9 to June 12. All in all, the injury took over a month to heal, and was in pretty serious pain until it was healed.
In the Fall (of 2008), I plan to return to Damascus, hiking to Pine Grove State Park in Pennsylvania, completing the first half of the Trail. What are preventative measures recommended by hikers to avoid this in the future, and what is recommended to be done on a daily basis (i.e., what kind of stretches) to keep this from haunting my future long-distance hikes?
I really want to be able to cover the next 630-miles of my hike without having to deal with this injury again. I can deal with blisters, wobbly knees, hunger, chafe, sore back, and the whole psychological aspect of missing family, friends, and what not; but, not a shin-splint as severe as I encountered last June!
take-a-knee
03-20-2008, 00:24
Try to find a Stairmaster Stepmill PT 7000 at a nearby gym and train on it 2-3 days/week,and, this is important, DON'T HOLD ONTO THE HAND RAILS! This will strengthen all the postural muscles in your lower leg, the tibialis anterior especially. Shin splints can also be caused by stress fractures in the tibial cortex/periostium. Not enough protein and calcium can set you up for that.
CocamoJoe
03-20-2008, 00:29
My injury very likely was a stress-fracture, all in all. I had broken a finger and a few toes in times past, and that distinct "broken-bone feeling" is the closest I can come when trying to describe the pain.
Man, I sympathize. I remember tripping and hitting my splinted (??) shin on a branch... I was down and crying for a good five minutes. There's nothing like it.
The only things that helped me were:
-stretching it as best I could by doing a reverse calf stretch - putting the top of my foot knuckles on the ground pushing until I felt it
-tying a bandana tight around the top of the shin, with the knot in the front.
Obviously it hurt enough that I didn't care what I looked like :)
I feel your pain. I still get them from time to time. Rest is only thing that helps me.
dessertrat
03-20-2008, 04:17
Exercise moderately with loads to strengthen, but don't overdo it.
How much do you weigh? How much does your pack usually weigh? What sort of boots/shoes do you use?
Finally, do you use trekking poles? Some people have strong anti-pole feelings, but they definitely shift some weight off your legs in the most stressful situations (up and down hills).
Finally, what sort of boots/shoes did you use, and why?
fiddlehead
03-20-2008, 04:31
I've never had shin splints. I hear they are very painful.
I am a long distance hiker first and an ultra runner/ marathoner second. (although i've done more of the latter lately)
Anyway, i think you get them from downhills too fast, or what i really mean is too stiff.
I use a technique for going downhills that helps me keep my body from getting injured (i think and hope) I'll try to explain it to those of you who want to try.
When going down a steep hill, bend your knees slightly so that they can act as shock absorbers, EACH step that you take you should pretend that you are stepping on black (slippery, hard) ice! And get ready for that next step so that you are not really putting all of your weight on that step. The next step, same thing. (It can feel sort of like skiing moguls for those who ski.) Try to keep your feet apart and keep those steps short! Sometimes it almost is like running in place. The worst thing is to have any joint from the waist down stiff. This seems to really save my knees and i think it should help to prevent shin splints also. Some would call it running down the hill and won't want to try it. It may appear as running but it works for me. I don't carry more than 30-50 lb packs anymore either.
Not so easy to explain with text. It's best if i could show you what i mean but that's not going to happen for a while.
CocamoJoe
03-20-2008, 04:57
Exercise moderately with loads to strengthen, but don't overdo it.
How much do you weigh? How much does your pack usually weigh? What sort of boots/shoes do you use?
Finally, do you use trekking poles? Some people have strong anti-pole feelings, but they definitely shift some weight off your legs in the most stressful situations (up and down hills).
Finally, what sort of boots/shoes did you use, and why?
I've started a relatively intense upper-body workout, and am going to start working the legs out at two of the parks where I live (Pittsburgh) which have moderate-difficult hikes I can make by piecing together certain trails.
I weigh around 150-pounds. When I started on Springer last May, I had around 45-pounds; when I left Neels Gap, I had around 35-pounds (each weight includes around 10-pounds of food and two-liters of water). My boots are medium "high-top" Northface boots (onsale for $60 at my former local outfitter in Augusta, GA; after almost 500-miles on the AT----not including hikes in the Adirondacks, New Mexico, and dayhikes to North Georgia!----are still in great condition). Upon arriving in Damascus, I bought Superfeet, new insoles, which are great.... much better than the original insoles. For my next leg of the A.T., I'm thinking of switching to trail-running shoes, and have been checking out a few models. When I have the specs on hand, I'll relay them to you if you'd like.
Regarding trekking poles: I always hike with a pair of Leki trekking poles. They were amazing on my hike (and, that includes in New Mexico, where I spent two-weeks at Christ in the Desert Benedictine Monastery near the Chama Canyon Wilderness Area and Continental Divide Trail, able to do a few hikes as my leg was mainly healed by this point----including a 12-mile round-tripper on the CDT, atop El Camino Mesa!), and, literally, saved my life several times. They were great for swatting away poison ivy, and maintaining much needed balance on certain sticky areas (I'm thinking of portions of the "Exposed Ridgeline Trail" in Tennessee). Also, I had read that they can transfer as much as 40% of the stress given to legs to the upper-body, thus making hiking an upper-body exercise, too!
I bought the boots I did because they were onsale, first and foremost. I was a month from flying to upstate New York to hike in the Adirondacks with some friends, and had no boots. I did try them on, an talk with a sales rep at the outfitter, and they did turn out to be a perfect buy. Between Springer and Neels, I got a bazillion blisters. At Mountain Crossings, Felicity (I think that was her name) showed me how to better tie my boots. After that point (the 30-mile point!), I incurred no more than 3-blisters per foot for the next 430-miles! I am not exaggerating at all! To be fair, I was using moleskin on an as-needed basis. Also, while talking with former thru-hikers at REI in Atlanta, I was recommended using ankle-support boots, to avoid getting stress-fractures in the ankles. All in all, I think I learned that I have really strong ankles; hence, my considering trail-running shoes....
Anyways, I'm going on and on, probably much too much detail. So, I'll end it here, allowing you to reply. If it'd be easier, feel free to PM me!
Mouthpiece
CocamoJoe
03-20-2008, 05:00
I've never had shin splints. I hear they are very painful.
I am a long distance hiker first and an ultra runner/ marathoner second. (although i've done more of the latter lately)
Anyway, i think you get them from downhills too fast, or what i really mean is too stiff.
I use a technique for going downhills that helps me keep my body from getting injured (i think and hope) I'll try to explain it to those of you who want to try.
When going down a steep hill, bend your knees slightly so that they can act as shock absorbers, EACH step that you take you should pretend that you are stepping on black (slippery, hard) ice! And get ready for that next step so that you are not really putting all of your weight on that step. The next step, same thing. (It can feel sort of like skiing moguls for those who ski.) Try to keep your feet apart and keep those steps short! Sometimes it almost is like running in place. The worst thing is to have any joint from the waist down stiff. This seems to really save my knees and i think it should help to prevent shin splints also. Some would call it running down the hill and won't want to try it. It may appear as running but it works for me. I don't carry more than 30-50 lb packs anymore either.
Not so easy to explain with text. It's best if i could show you what i mean but that's not going to happen for a while.
Thanks for the recommendations! While I was reading your descriptions of your downhill method, I got a perfect visual in my mind. Regarding the stretch with the toe "knuckles": when I decided to end my hike, I got a ride into Bristol, TN, where I took a Greyhound Bus back home to Augusta, GA, where I'm from and was living at the time. I had several hours to spare, so found a restaurant where I got a burger and a few beers. Lo and behold, my waitress was a sports medicine medic (not a doctor, she kept emphasizing) for sports teams at one of the area universities! She confirmed for me that I was making the best choice by hiking, to avoid exacerbating the injury, and possibly incurring lifelong injuries. Before leaving, I asked her about any shin stretches, and she showed me that "knuckle" one you described----which I've frequently used ever since!
Frolicking Dinosaurs
03-20-2008, 05:09
This routine (http://www.sportsinjurybulletin.com/archive/0161.htm) has helped me avoid shin splints for several years now. It was recommended by my physical therapist.
CocamoJoe
03-20-2008, 05:15
This routine (http://www.sportsinjurybulletin.com/archive/0161.htm) has helped me avoid shin splints for several years now. It was recommended by my physical therapist.
Thanks a million! My brother in law recommended getting those tacky-looking ankle weights (you know, the one's that wrap around your ankle), putting them on your feet (foot, I suppose, as you can only do this exercise with one foot at a time). Stand upright, propping yourself on something (mainly for balance); you can even sit down, although standing will optimize the exercise to its fullest potential. Simply "[b]ring[ing] your toes as far toward your shins as you can, and then lower[ing] your feet back toward the ground, but do not allow[ing] your forefeet to contact the ground before beginning the next repeat. Simply lower them until they are close to the ground, and then begin another repetition..." as the website you posted says.
Have you tried anything like this? He showed me this massive muscle he has on his shin---mainly from running---which he referred to as the "don't get a shin-splint muscle"!
Also a runner and know when I begin to experience even the slightest hint of a shin splint, I have to change out my running shoes, as I've worn out my support. As soon as I rest a day and return with my new shoes (never to use the ones I had one again), I have no pain. I do think it is imperative to make sure you have the adequate support your foot (not necessarily your ankle) needs to support the weight of your body and pack.
I hike with a well-supported trail runner, and it works well for me. No recommendation on what you hike in, just that you find what your body needs for its best support.
Frolicking Dinosaurs
03-20-2008, 05:27
Thanks a million! My brother in law recommended getting those tacky-looking ankle weights (you know, the one's that wrap around your ankle), putting them on your feet (foot, I suppose, as you can only do this exercise with one foot at a time). Stand upright, propping yourself on something (mainly for balance); you can even sit down, although standing will optimize the exercise to its fullest potential. Simply "[b]ring[ing] your toes as far toward your shins as you can, and then lower[ing] your feet back toward the ground, but do not allow[ing] your forefeet to contact the ground before beginning the next repeat. Simply lower them until they are close to the ground, and then begin another repetition..." as the website you posted says.
Have you tried anything like this? He showed me this massive muscle he has on his shin---mainly from running---which he referred to as the "don't get a shin-splint muscle"!I would be unable to do this exercise with my right leg due to having a paralyzed vastus lateralis (http://en.wikipedia.org/wiki/Vastus_lateralis_muscle) from an auto accident. It likely would work.
As Gumball says, support is important. I use superfeet in my shoes to maintain proper alignment.
CocamoJoe
03-20-2008, 05:40
I would be unable to do this exercise with my right leg due to having a paralyzed vastus lateralis (http://en.wikipedia.org/wiki/Vastus_lateralis_muscle) from an auto accident. It likely would work.
As Gumball says, support is important. I use superfeet in my shoes to maintain proper alignment.
One of the first things I did upon limping into Damascus after an 18-mile hike, was purchase SuperFeet. What an amazing purchase!
Pack could be a factor (45 lb, then 35 lb) if you weigh 150.
CocamoJoe
03-20-2008, 06:35
I'd usually be right around 25 when coming in to town, with low water and food; with 35-pounds upon leaving again...
Long Island Ice Tea
03-20-2008, 09:30
lateral and linear step movements with light weights and/or ankle bungees and higher reps 13-20 a leg. This is a good way to finish a leg workout.
Single leg isolation movements etc will also help.
At least this is what my trainer suggests after your leg has recovered.
R.I.C.E. rest ice compression elevation...if you aren't there yet... GL
I've had shin splints and a tibial stress fracture in the past, and I have a few suggestions:
1) Do exercises to strengthen your lower leg muscles, especially the muscles on the front/outsides of your shins. The website suggested by FD has some good ones.
2) Lighten your load! With a relatively small investment, you should be able to get your base weight (without food/water) well below 20 lbs. Maybe below 15. Each pound less on your back is that much less on your shins. Lighter shoes will help, too. If you post a gearlist here, you'll get a million tips on how to lighten up.
3) At the first sign of shin pain, change your routine. If you're on the trail, take a day off, ice your shins, or reduce your mileage. If you're training, cut back for a few days. Usually a stress fracture is preceded by shin pain, so you have a built-in early warning system. Listen to your body.
4) Stretch. Calf stretches are really helpful for shin splints, and some people recommend hamstring stretches (toe touches), too. Try stretching every 2 hours or so on the trail, and definitely stretch whenever you stop hiking for a while--your muscles will tighten up when you stop moving.
I got my stress fracture 6 weeks before I started a long section and ended up going 900 miles with no problem, so it's possible to get past shin issues. Good luck.
Johnny Thunder
03-20-2008, 09:45
If you got the shin splints early on it was probably from overusing a muscle...going down hill too fast, etc. If they came on later then it was probably because your calves got too strong and the shin splints didn't grow quickly enough to compensate. Think of sprinters who tear their hamstrings. A good way to avoid the calf muscle pulling too hard on the shin splint is to stretch the crap out of your calves. Works for me.
Appalachian Tater
03-20-2008, 10:58
An excellent mini-presentation on shin splints:
http://www.mayoclinic.com/health/shin-splints/DS00271/DSECTION=1
playing soccer in high school we encountered these quite often. a sharp pain running down the muscle to the outside of your shin bone (tibia). stretching is really key, but also to consider is caffeine reduction. the guys who always got em were the ones drinking 1/2 gallons of iced tea before/during practice, and the guys who infrequently got them were sticking w/ water... as was mentioned, think of the opposite muscle (calf) as far as maintenance. the majority of back problems are caused by weak and underdeveloped stomach muscles - same principle applies here...
A 25-pound base weight is still really, really heavy. During my "luxury" tryst through New England antic last summer (jetboil in tow!), my base weight was never over 8 or 9 pounds. I mean, if you have shin splints that threaten to end your hiking career, I feel like the first step is to get as light as possible with gear. Heck, use it as an excuse to become one of those crazy super ultra-light dudes.
mkmangold
03-20-2008, 22:22
We humans pretty much over-develop our posterior muscles, just by virtue of being upright. In fact, standing alone can cause shin splints (ask any assembly line worker). But walking and running speed up the over-development process. Think of your lower leg in this case as consisting of posterior (calf) muscles, feet ligaments, and anterior (anterior tibialis) muscles. With the foot as a fulcrum, what would happen if the posterior muscles over-develop compared to the anterior? First, stress on the Achilles tendon (too much or too rapidly... Achilles tendinitis). Then, the feet... plantar fasciitis. Finally, pulling on the anterior leg stresses the tibial bone... shin splints. Very painful. In addition to NSAID's, rest, ice, and stretching, I recommend strengthening the anterior muscles (try lifting a sandbag planted on your toes with flexion upwards at the ankle) and making a nighttime splint to keep your foot at 90 degrees. During the night, our feet normally plantar flex, resulting in even shorter calf muscles.
I got shin splints on my Georgia section hike. "Too fast, too far, too soon," as I read in a book once. It took me about 2 months of taking it easy at home to get over them. Then I went hiking again! :p
I feel your pain too. They're no fun! I was plagued by them on the PCT after not dealing with them the whole AT, or in my previous 5000+ miles of hiking. Got them 1700 miles into the trail, on one of the EASIEST sections of the whole trail (southern Oregon). The trail got incredibly flat, and I got incredibly stupid, trying to cover 3-4mph for 10 hours a day.
I hobbled the final 800 miles with really painful shins, doing big miles to finish with the pain, since slowing down was not helping (when you got em', you got em'.) Icing helped, but after awhile, I just needed to stop hiking.
Even now, 6 months later I can still feel the pain occasionally, if I don't stretch well before hiking or running, or going down hills too fast.
Really, I have no real advice to share, but support and empathy. Try and talk to a PT or look up stretches online. DEFINATELY take it slow on your next hike and keep the pack light. Stop each day while you still have energy, and don't max out the first couple weeks. And take zero's every once in awhile. I went 500 miles on the PCT and AT without a zero. Stupid!!
Good luck, and PLEASE share anything you learn. We could all use the advice.
BackTrack1
03-20-2008, 22:38
I had shin splints about 2 yrs ago, went to my doctor and he told me to go out and buy some super feet insoles,
beleive it or not, i havent had a problem since,
envirodiver
03-20-2008, 22:45
My daughter is a soccer player and she had recurring shin splints for several years. We found a taping method that helped, but did not preevnt them completely. We finally did enough research and looked hard at her shoes and the fact that she pronated a bit. I took her to a running shoe store that had very experienced people working there. The man was a coach for long distance runners and marathoners. He had her run away and then back toward him. Put her in a pair of running shoes and inserts for her soccer boots. She has not had shin splints since then. We have to change her shoes/inserts after about 300-400 miles.
Go see a specialist regarding shoes and running. it took us a while to find someone that really did know. Just cause they work in a running shoe stroe doesn't mean thay can get this.
Blissful
03-20-2008, 23:31
I agree to seek out professional help with footwear. And a Sports MD might not be a bad idea to start.
mark.k.watson
03-21-2008, 00:13
I have had severe shin splints and severe stess fractures in both legs. Docs will tell you to start slow and increase only 10 percent each week.
My advise, go slower to build up, stretch, stretch and stretch. Any leg stretch that you can thin of. My favorite is to sit with my legs out straight and have a buddy push my toes down slowly. Hurts at first and then feels great. If alone, get on your knees with your toes straight backwards, lead backwards slowly untill you feel the burn.
Take it easy and come back slow.
CocamoJoe
03-21-2008, 03:37
You know, my shin-splints started on the easiest section of the A.T. I had hiked so far, too! I was past Roan Mountain, and shooting for a 25-mile day. At 15-miles, at Dennis Cove Road, I had to call it quits for the day, and ended up staying 3-nights at Kinkora Hostel because of my shin-splint. I zeroed the next day; slackpacked for 9-miles (Watuga Lake south to Kinkora); and went back to the Trail the next. When I went back to the Trail, for some dumb reason, I thought it wise to shoot for big miles again, and ended up doing 23.5-miles..... the last 6 of which were absolutely brutal. I remember stopping for a break at the 17-18-miles mark, at a shelter, where I had my dinner (figured, "If I eat my dinner now, I can go straight to bed when I get to camp 6-miles North of here!" hahaha, I still cooked a meal when I go to camp that night!). It was no more than a mile North of there, near the Nick Grindstaff memorial when the splint started rearing it's ugly face again, smiling it rotted teeth, exuding its noxious breath... Then, with the damn thing, I hiked 18-miles to Damascus the next day!
Regarding insoles, I bought SuperFeet at Mount Rogers Outfitter, and could tell a near immediate difference. Also, after leaving the A.T., about a month later I found myself at Christ in the Desert Benedictine Monastery in the high desert of northern New Mexico (about an hour North of Santa Fe, before veering off on a "forest" service road, which takes about another hour, due to the bumpiness). I did a 12-mile day hike on the CDT, and felt great; and, also took advantage of some of the canyon hiking in the area (I was in the Chama Canyon Wilderness Area). My leg never once bothered me while I was hiking in New Mexico!
Mark, regarding the last stretch you detailed, upon arriving in Damascus, a 50-something year old lady taught me that stretch (as I likely had a stress-fracture, imagine how badly it hurt!), and gave me a heaping portion of blueberries, as they're loaded with calcium! Friends, acquaintances, and coworkers, when experiencing leg or back pain, generally ask me for advice regarding stretching. I recall at a temporary job I had not too long ago, explaining the logic behind some of these stretches to this one girl with whom I worked. We certainly looked funny doing these stretches----including a yoga one my masseuse taught me in Hot Springs!----at work, but her legs felt so much better afterwards, she said!
As others have said, shin splints that are muscle pain often result from your calf muscle being stronger than the shin muscle (tibialis anterior)
A way to solve this is the tibialis strengthening exercises that Dino linked to. I also got shin splints every year from soccer and I just ran through it until they eventually went away. This was my tibialis slowly getting stronger on its own. When I got to college I took a weight training class where we did toe lifts that strenghten the tibialis anterior, and when I took running later I never got shin splints!
But for stress fractures I don't really know much :-? It's a good idea to talk to a doctor or physical therapist or both!!! It may be expensive but worth it to not be in pain.
mark.k.watson
03-24-2008, 10:05
Mark, regarding the last stretch you detailed, upon arriving in Damascus, a 50-something year old lady taught me that stretch (as I likely had a stress-fracture, imagine how badly it hurt!), and gave me a heaping portion of blueberries, as they're loaded with calcium! Friends, acquaintances, and coworkers, when experiencing leg or back pain, generally ask me for advice regarding stretching. I recall at a temporary job I had not too long ago, explaining the logic behind some of these stretches to this one girl with whom I worked. We certainly looked funny doing these stretches----including a yoga one my masseuse taught me in Hot Springs!----at work, but her legs felt so much better afterwards, she said!
Yup It is a stupid looking stretch, but Ohhhhh it feels great.
I too had severe stress fractures. I got them in basic training and I was too stuborn, read stupid, to go get them checked out by the docs. By the time I finally went in, my shins were purple, they were swollen to the point that they were nearly as big as my thighs, no joke there, and the docs could easily see the breaks in both shins on the x-ray rather than a bone scan.
Needless to say they chewed me out.
My legs continue to plague me today whenever I run, therefore I don't anymore. Walking and hiking is ok as long as I build up slowly.
All, take my advise. If your legs are still hammered after RICE, rest, ice, compress, elevate, go see the docs.
saimyoji
03-24-2008, 10:35
Brussel sprouts. My mother always made me eat 'em growing up, and through track, soccer, baseball....I never once had shin splints if I ate those nasty veggie balls. They must work. :cool:
Brussel sprouts are wicked tasty. What ails you?