This week, Bobbi Conner talks with Dr. Alec DeCastro about shin splints and stress fractures in runners. Dr. DeCastro is a Professor and Program Director for Primary Care Sports Medicine in the Department of Family Medicine and Orthopedics at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Shin splints are a common injury among runners. Doctor Alec DeCastro is here to talk about shin splints and also stress fractures, and provides strategies for prevention. Doctor DeCastro is a Professor and Program Director for Primary Care Sports Medicine in the Department of Family Medicine and Orthopedics at MUSC. Doctor DeCastro, first, tell us about shin splints in runners, and some of the typical symptoms for this injury.
Dr. DeCastro: Shin splints is otherwise known as medial tibial stress syndrome. It's pain along the inner edge of the shin bone where the tissues are being overloaded. Runners usually describe a broad, achy or tender area rather than one pinpoint spot. It often starts early in a run, may ease as they warm up and returns afterwards. Most of the time it develops gradually, rather than one step or a sudden injury.
Conner: And what causes shin splints, especially in runners?
Dr. DeCastro: At its core, shin splints is really a bony overload injury, not simply inflammation of the tissues around the bone. So, running can create microscopic stress in the tibia. And during recovery, the bone remodels and then grows stronger. So, the problem begins when loading outpaces that repair process. Often, it's usually due to a sudden increase in mileage or intensity, or returning too quickly after a layoff. Other things like body mechanics, higher body weight, another running injury, or certain hip mechanics or ankle mechanics can add additional risks. Usually, those several factors are working together.
Conner: And what's the best treatment if someone does in fact have shin splints?
Dr. DeCastro: The buzz term now in sports medicine is called load management. I tell runners to turn the training dial down below the level that causes pain, not necessarily stop all exercise. So, non-weight bearing exercise like cycling, pool running, elliptical can help maintain fitness until they're pain free. Then we progressively rebuild ankle, hip, core strength and address training, footwear or biomechanical issues. Once walking, and the shin tenderness and pain are pain free, they can begin, walk and run intervals, and distance before speed. They can progress only if there's no pain during or after the next day. Things like shockwave therapy can help stubborn cases, but only as an adjunct to rehabilitation.
Conner: What can runners do to prevent shin splints?
Dr. DeCastro: Prevention is mostly balancing training with recovery. You can build mileage and intensity gradually. Avoid hills, speed work and a long run in the same week. Replace worn shoes and choose shoes that's comfortable with you. Keep the calves, feet, ankles, and hips strong. But just as important, get sleep, fuel adequately because muscles and bones need time and nutrition to adapt.
Conner: Tell us about another injury that runners sometimes experience stress fractures.
Dr. DeCastro: Stress fractures can develop just like shin splints as a spectrum of tibial overload. So, shin splints cause diffuse tenderness over several inches. A true stress fracture is a higher grade injury with a fracture line. So, clinically the pain becomes more focal, progresses to pain after running, pain during running and eventually pain with walking or at rest.
Conner: And this is a condition that should be evaluated by a physician.
Dr. DeCastro: Absolutely. The big thing is that we don't want the stress fracture to progress or get worse and cause an injury that might require surgery.
Conner: Doctor Dr. DeCastro, thanks for talking with us about shin splints and stress fractures.
Dr. DeCastro: You're welcome.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
