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Scott Drum, Ph.D, FACSM December 28, 2011 TWEET COMMENTS 7

What's That Thorn in My Shin? - Page 3

If inflammation is absent, says Poppe, then some running may be OK if performed with minimal pain. Avoid running on hills, uneven terrain and overly firm surfaces, and refrain from high mileage and speed workouts until all discomfort dissipates. Also, consider adding cross training to your agenda, such as swimming, pool running and utilizing an elliptical machine or stationary cycle. Normally, after a few weeks of lying low you can ramp up the frequency, duration and intensity of your training.

If your shin pain becomes more severe or chronic, especially with sustained swelling, despite conservative treatment, curtail your mileage further or stop running completely.

Prevention

Visit a specialty running retailer for a gait analysis. Also, purchase well-fitting running shoes, and replace them every 300 to 350 miles to ensure optimal cushioning. Orthotics that correct diagnosed biomechanical foot issues may also be warranted.

Additionally, maintain strong core muscles to promote or improve running mechanics and add strength training to your exercise routine, especially movements that target stabilizing muscles of the lower extremities.

"Overpronation is a common, possible cause of shin splints," says Poppe. "Therefore wearing the appropriate shoe with a footbed that helps reduce overpronation may help. However, core and balance/proprioceptive exercises are still key to preventing repetitive trauma injuries of the lower limbs."

According to Dr. Craig, no single method has been proven to consistently deter the onset of MTSS, but the most effective seem to be shock-absorbent insoles, pronation-control insoles and graduated running programs. "Stretching of the lower-leg musculature, however, has been consistently proven to not prevent MTSS," says Dr. Craig. Therefore, attempt to choose strength training exercises over excessive stretching to optimize prevention and/or recovery from shin splints.



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