- Reduce activity to pain free levels for at least one week.
- Ice the involved area for 30 minutes 3x/day.
- Change your athletic shoes if they may be worn down.
- Minimize your speed workouts and hill workouts.
- Consider if levels of Calcium and Vitamin D may be low.
- Attempt 3 to 4 days/week alternative exercises as long as it is pain free (i.e. cycling, elliptical, walking, swimming, court sports, etc.)
- Stretch the achilles tendon 2 positional (knee straight and knee bent) for 1 minute each 3x/day.
- Experiment with an ankle brace or ankle taping if it is painful to walk.
- Wear tie-on supportive athletic shoes full time while the shin is healing (although you may experiment with clogs as an alternative).
- Attempt pain free muscle strengthening of the muscle group involved.
Medial shin splints involve a group of muscles (with most commonly associated muscle function) including the posterior tibial (controls over pronation), flexor hallucis longus (stabilizes the big toe), and the flexor digitorum longus (stabilizes toes 2 to 5). Photo below shows where medial shin splints occur. Since over pronation, bunions (unstable big toes), and hammertoes (unstable lesser toes) are all common problems, this type of shin splint is the most common. More specific treatments of these problems include various methods in controlling pronation, stablizing the big toe area or stablizing the lesser toes.These include toe separators/spreaders, shoe inserts with Morton’s extensions, big toe spica taping to stabilize the big toe area, and toe crests, toe taping, reverse Morton’s extensions all to stabilize the lesser 4 toes.
In general, soleus strengthening is done with the knee bent 45 to 90 degrees and the ankle is then plantarflexed with resistance (pointed downward like a ballerina on her pointe shoes). Treatment of this type of shin splints must initially rule out a tibial stress fracture which requires other treatments and concerns. Once tibial stress fractures are ruled out by x ray or bone scan typically, functional changes include decreasing ankle plantarflexion (extension) and stabilizing pronation. Also, avoiding activities that produce a negative heel effect where your heel is unsupported and drops below the plane of the forefoot, like getting off your seat in cycling. A slight biomechanical change in activities to minimize heel lift (ie. walking more flatfooted even when going up hills, or lowering the seat on your bike) can greatly speed up treatment.
On this front view of the tibias, see the intense dye uptake in the middle of the left tibia. Since Christina is fourteen, she is still growing so her growth plates near the knees and ankles are still very active.
Here is a side view of both tibias with the left again showing the spot where the tibia broke.