3. I have been told I have ‘shin splints’. What is it? Is surgery the only option for relieving this problem?

The term ‘shin splint’ refers to pain in the lower part on the shinbone or tibia. The pain is usually caused by the muscles that run along the tibia being loaded unevenly. Inflammation results in the sheath that connects the muscle to the bone, the periosteum. Sometimes there is a build up of this fluid and swelling, and a compartment syndrome may occur. Surgery might be required to treat this condition, but physiotherapy must be tried first. If you do not reduce your training or establish why you have this pain when you first feel it, a stress fracture of the bone can result. This is a hairline fracture that does not show up on a regular x-ray until six weeks after it has occurred.

Some of the causes for shin splints and what to do are outlined below:

• Tight calf or hamstring muscles. Start stretching the calf, Achilles and hamstrings more regularly. These can be found in Francine's Bodyworks book
• Old or non-supportive shoes. If you jog regularly (three or four times per week for approximately 30 minutes on hard surfaces), you should be replacing your shoes at least every six to eight months. If you train more frequently and for longer times or distances, you need to change your shoes even more frequently.
• Overpronation or other faulty foot mechanics. If you have a bunion on your big toe, or you get blisters or calluses after exercising, this can indicate you are not loading the foot evenly. If your pain is persistant even once you have received treatment, it is time to see a podiatrist and/or get your postural mechanics checked by a physiotherapist.
• Excessive training or increasing your distances too quickly, particularly if you are a long-distance runner. If there is any early sign of shin pain, reduce your distances until you solve what the problem is.
• Other biomechanical reasons such as a difference in leg length, the structural shape of the shinbones or pelvic or trunk instability may also lead to shin splints. It is time to get an assessment of how you walk or jog by either a podiatrist or a physiotherapist.

If you experience some mild shin pain after one particular run, immediate care is to apply ice to the area using an ice cup massage (Refer Bodyworks Book pp.32). It is a difficult area to stretch, however. If you sit on the floor with the ankles tucked under you and lift one knee off the ground using your hand, you may be able to stretch this area. Alternatively, try lying on your back with a towel around your foot and taking the leg into the air. Stretch the calf muscle for two to three minutes. By pulling slightly on the outside of the foot you can often get a specific shin stretch. This stretch will ease any mild shin pain following exercise.