Shin Pain

Tedd Girouard MS, LAT, ATC
Head Athletic Trainer FC Las Vegas

It is not uncommon for athletes in soccer and other sports requiring constant running to experience pain in their shins. This problem is commonly called "shin splints". Unfortunately, this blanket term does not accurately describe all shin problems. Shin pain problems are generally classified by the location of the pain. If the pain is on the front outside (little toe side) of the shinbone (Tibia) it is commonly called anterior compartment syndrome and is a more severe problem that should be seen by your family doctor. If the pain is on the inside (big toe side) of the shinbone, it is commonly called shin splints and tends to be a less severe problem. If the pain is directly on the shin bone, it may be a combination of injuries or a bone injury such as stress of a fracture which also needs to be seen by your family doctor.

So what causes shin pain? Do you notice that your shin pain usually occurs at the start of a new season? Recent evidince suggusts that a high perecntage of patients exhibiting shin pain may have bone loss due to increases in training volume. This is common because one day you start playing and are asking the muscles and bones in the shin area to work harder then they have for months. In order to avoid this type of shin pain, you should start training on your own several weeks prior to the start of your team training. Start with shorter less strenuous training sessions and work your way up to longer more intense workouts.

Other factors could also be the cause of your shin pain. One possible cause is the improper fitting of shoes. You should buy your shoes from someone with knowledge of foot biomechanics and shoe fitting. Soccer players tend to purchase shoes that fit tight for better "feel" on the ball. The tighter the shoe, the greater the chance that the muscles of the lower leg will not function properly due to changes in your foot mechanics when you run. Fitting shoes too tight can create problems in the long term. If you have a high arch and you buy a shoe with no arch support you are asking for shin pain, the same holds true for someone having a low arch and using a shoe with a high arch support. Other factors to keep in mind when buying and wearing new shoes are; proper lacing, playing conditions, shoe wear patterns, and quality of the shoe. Soccer shoes as other shoes provide more support when they are tied properly. Shoes should also be selected based on the conditions you are going to play on most frequently. In some areas you tend to play on extremely hard surfaces, so a molded cleat would be better then a screw in. Where as, other surfaces maybe softer and a screw in cleat might work better for traction and overall muscle function.

So how do we treat shin pain? The best answer is rest. However, we all know that rest is not always the option a player can or wants to follow. So treatment will depends on where the pain is located. If the pain is directly on the bone, rest is probably the best course of action (check with your doctor). If your pain is on the inside or outside of the shinbone you should ice after each training session. The best way to ice these areas is with an ice cup. To make an ice cup, fill a paper cup with water and freeze it. Take the frozen ice cup peel off the top 2 or 3 inches of the cup, holding the cup portion rub the large end of the ice over the area of pain for 5 - 8 minutes.

If your pain is located on the front/medial or big toe side, stretching your calf muscles out several times a day may also be helpful in relieving the shin pain while you continue to work out. Start on an incline board (See Photo Right) or perform a traditional calf stretch (See Photo Below). Hold each stretch for 15 seconds and do this 10 times. Try to do this stretch three or more times each day. If the pain is on the outside you should stretch the front of your lower leg by placing your toes straight up and down on the ground and push your ankle forward (Opposite of a calf stretch). DO NOT use a compression wrap on shin pain injuries because the problem is usually associated with having too much compression in the area already. By wrapping your shins with tape or and elastic bandage you can increase the compression and resulting pressure in the shin area which could actually do more harm than good.

Slant Board Stretch

Traditional Calf Stretch	Remember if your pain persists or continues to get worse stop your activity and seek medical attention from your family doctor.