Shin Splints Stages

Shin splints are one of the most common aches and pains encountered in active people. Most commonly seen in running athletes, shin splints can be a very debilitating condition resulting in lots of time out of sport when poorly managed.

Stage 1

The condition usually presents as pain along the inside of the shin bone down near the ankle. Initially shin splints might feel sore at the start of your warm up, but disappear quite quickly. This is one of the biggest challenges for athletes, particularly young athletes, in that they think the condition is not a problems because it ‘warms up’ or goes away. In the early stages there might not be too much pain after a training session again resulting in athletes down playing the problem.

Stage 2

As shin splints progress athletes find that the shins are sore during the entire warm up but disappear by the end of the session – again having this ‘warming up’ effect. But once exercise stops and an athlete cools down, a dull aching pain might persist for an hour or so after stopping exercise. This stage is really important as pain after stopping exercise indicated an inflammatory nature to the problem and continuing to train through this without sufficient recovery will result in an accumulation of this inflammatory response.

Stage 3

If athletes do not seek help, they will usually progress into the next stage – one where the pain actually worsens with more exercise. It is usually at this stage we see athletes coming in, because they are finding it too hard to push through the pain and it’s effecting their training load. Unfortunately, this is well advanced now and becomes a longer issue to settle. If athletes do continue to train through this stage, they may develop resting pain – where the shin/s are sore getting up in the morning, or just walking around doing their daily tasks. This is quite serious as it can indicate a sufficient amount of bone stress has occurred and perhaps a stress fracture is present.

Depending on what stage you present to physio is a great indication of how much modification to your usual training programme will be required – the earlier you present, the sooner we can offload the inflamed tissues and give you the right advice. It’s interesting as most people present in stage three, I would have to say anecdotally that most people will need at least 4-6 weeks of modification to their usual programme involving cross training, training surface changes and deloading. Athletes do not realise that whilst 4-6 weeks at the early part of a season might not be a huge impact, it’s actually the losses that occur towards the end of the season that are more noticeable. That initial 4-6 weeks, or almost two entire training blocks for some athletes, will mean they are two training blocks behind as the season comes to the pointy end of it all. Not only this, but athletes will tend to rush back into doing training exactly as they were before having 4-6 weeks of deloading and unsurprisingly they end of with the same problem happening again.

My advice would be:

1) whilst shin pain might not seem like a ‘big deal’ it can make or break a season – so the sooner you address it, the less training time you lose

2) do not try and push through – seek physio advice on how to intelligently train / cross train / modify your training load

3) your coach needs to be on board with your physio and vice versa – without your coach understanding why and what is happening, they can be your worst enemy

Written By Josh Carter