Shin Pain

One of the most common complaints of people in the beginning days of a new walking or running program is shin pain. Typically, the pain is on the outside part of the shins, in the muscular part. This is usually not of significant long-term concern. Pain located on the inner part of the shins along the bone is more concerning.

The first question that comes to mind when outer shin pain occurs is whether the person should continue with their new exercise plan. Generally speaking, it is OK to continue with some intermittent rest days, some stretching and possibly some ice massage. The muscle that is the cause of the pain is called the anterior tibialis. Its job is to bring the foot up toward the shin (opposite of pushing the foot down, as if putting on the gas). During walking, the anterior tibialis pulls the foot up as the leg swings through and positions the foot so that the heel will strike first while striding forward. When overworked, this muscle gets sore and tender to the touch. As with most muscles, when given some rest, the anterior tibialis will usually recover and the pain will subside. For most new exercisers, the pain will gradually subside as the muscles gain strength and endurance. However, in order for the muscle to adapt properly, the exercise needs to continue but with little to no increase in distance or speed until the symptoms improve. In addition to cautious progression and icing, stretching of the anterior tibialis after exercise is recommended. As with all stretching for recovery, hold the stretch for 30 seconds and do the stretch twice for each leg. (See pictures included.)

If worsened, a serious condition called anterior compartment syndrome can result. This problem is caused by the compression of nerves and blood vessels in the lower leg by the anterior tibialis muscle when it gets stiff and inflamed. The symptoms of ACS include deep leg pain, numbness in the foot, loss of circulation to the foot, tight and hot sensations in the shin muscles and drop foot (inability to bring the foot up using the anterior tibialis). The irony is that the overuse of the anterior tibialis causes the nerve that controls the very same muscle to be injured. Symptoms of ACS should be reported to your physician before continuing an exercise program. As with many overuse conditions, prevention is far more effective than treatment. To prevent compartment syndrome, focus on gradual progression of the program and perform stretching of the lower legs after each session.

Remember to listen to your body and take rest when needed, but keep progressing with your exercise program in a gradual manner. Your legs will thank you.