Tried everything to cure your shin splints? This one easy change could help fix your agonising problem – without medication or side effects

Older people have been warned against falling into a ‘winter hibernation’ that can lead to an agonising lower leg injury.

Shin splints, known medically as medial tibial stress syndrome (MTSS), is a condition often associated with endurance athletes, or those taking up a sport for the first time. However, older people are also at risk from the problem – even from low-intensity activities such as walking.

Doctors fear that few people realise one of the most common triggers is returning to exercise after a period of inactivity – such as over the wet and windy winter months.

They are urging those at-risk to do daily light exercise over the next few months to ward off problems in the spring.

‘It is really common in clinics to see patients in the spring who have come out of a winter hibernation, try to go on a long walk and are left suffering from shin splints,’ says Dr John Veto, an expert in podiatry health at the University of Stirling. ‘So it is really important to stay active now – even light exercise in the house can help keep them at bay.’

The condition is caused by inflammation in the tissue around the shin bones, and for some it can be persistent and debilitating. They can experience sudden, intense pain along the shin – the front of the part of the leg between the knee and foot – or a dull, nagging pain.

This kind of injury is especially common in sports such as football, rugby and track and field, affecting between 4 per cent and 35 per cent of athletes, and up to 20 per cent of runners, as shin splints are primarily caused by overuse.

However, even small changes in exercise levels can lead to the injury. Other triggers include being overweight, having one leg longer than the other, tight calf muscles or being flat footed.

Research suggests that women are more likely to suffer from the condition, with clinicians saying it is particularly prevalent in those who are post-menopausal.

Dr Veto also warns that a common trigger is wearing worn out trainers: ‘The sole flattens over time and loses its protection, so even if trainers look pristine they could be causing problems.’

Studies of soldiers have shown that exercising in unsuitable or worn-out boots increases their risk of overuse injuries in the lower legs, including shin splints. Diet may make a difference, too – not enough calcium can make patients more susceptible, as will a vitamin D deficiency, since it’s vital for calcium absorption.

To keep shin splints at bay, there are a number of exercises that can help. Experts recommend a ten-minute daily routine to strengthen the lower leg muscles.

Mr Mark Gallagher, consultant podiatrist at The Priory Hospital in Birmingham, says: ‘The one exercise I recommenced to everyone who is active, is calf raises, and I recommended doing four sets of 20 every other day.’

This is an exercise where patients move from being flat footed to up on the toes, holding for a second at the top, before returning the heel to the ground.

Other effective exercises include walking short distances on the toes and stepping on to and off an elevated surface, such as a box or bench.

Or there is the towel stretch, which involves laying down on the back and looping a towel around the foot. Then while keeping the leg straight, patients should gently pull the towel towards them. When they feel the stretch in the calf, they should hold this for up to 30 seconds.

Experts also advise warming up thoroughly and stretching the calf muscles and the Achilles tendon – the connecting tissue between back of the leg and the foot. Walking or running on grass, rather than the pavement, is recommended. And research shows that slowly increasing the length and intensity of exercise reduces the risk of shin splints.

However, once the pain has developed into shin splints, the best course of action is rest and the problem usually resolves itself over three to four weeks – continuing to train during will only prolong recovery and increase the risk of more serious injury.

Doctors also recommend taking anti-inflammatory medications, such as ibuprofen, while the same exercises mentioned earlier for prevention are also useful for pain management.

However, if the pain persists a GP may have to refer patients to a specialist for a scan or X-ray, or to a physiotherapist who can devise a rehabilitation programme. This is because it can sometimes be difficult to distinguish between shin splints and a stress fracture – a small break in the bone – because both injuries can occur in similar places from overuse.

But shin splint pain generally occurs along a broad stretch of the shin, while stress fractures typically feel tender to the touch in one spot.

‘If it is an activity-related injury it should subside at rest, but if it persists then it could be something more serious like a stress fracture,’ says Dr Veto. ‘So it is important to see a podiatrist or a GP’.