A Guide to Shin Splints: The Most Frustrating Injury in Drum Corps
By: Seth Davis, Carolina Crown AT Intern, and Elliot Cleveland, PT, DPT
Most of us have probably heard of, had, or know someone that has had shin splints but what exactly are shin splints? More importantly, how do we deal with shin splints - especially in the marching arts setting where we may not have time to sit out for a few days and rest? These are questions I have faced when treating members in the marching arts and are questions I am sure many of you have had before as well. To understand how to deal with shin splints, we first have to understand what exactly that term means.
What are Shin Splints?
Shin splints, known as medial tibial stress syndrome in the medical world, is a term that describes the inflammation of the muscular, tendinous, or boney tissue in around the tibia (1). We often feel this pain directly over or around the tibia that can range from a small area to the entire surface area of the tibia.
In the sports medicine world we typically see this as a result of overuse. Shin splint pain can develop quicker or become more severe in people with flat feet or people who exercise without the proper footwear (which is why we in the marching health and wellness community stress proper footwear so much). Shin splints themselves may not be much of an emergent issue, but overtime as the stress continues it can develop into a much more significant issue, such as a stress fracture. Because of this it is important that people who have or may have shin splints deal with it at the first sign, or better yet be educated on how to prevent them in the first place!
So now that we know what shin splints are, how do we prevent or treat them?
Treating Shin Splints
R.I.C.E. - Rest. Ice. Compression. Elevation.
This is one of the most common acronyms in rehab and has withstood the test of time. Shin splints are treated with rest, consistent ice (20 mins on, 1 hour off), compression wrap for short-term relief, and NSAID’s (Non-Steroidal Anti-inflammatory drugs) such as Ibuprofen and Aleve.
The R.I.C.E. method is great for a setting where there is plenty of time to take off and rest. However, during in the drum corps setting we don't always have the luxury of time off, and the treatment often needs to be more consistent and intense.
Preventing Shin Splints
Avoid Muscle Imbalances
In my experience, those treatments along with consistent strengthening and stretching of ALL the lower leg muscles are great in the prevention and treatment of shin splints. I emphasize ALL of the lower leg muscles because the problem that most marching athletes have is that their calves are plenty strong, but they neglect the other muscles in the lower leg (invertors, evertors, and dorsiflexors). This creates a force imbalance that can put more strain on the tendinous structures and musculature that can lead to an increase in symptoms.
Get in Shape
Research has shown that shin splints are caused by increasing activity too quickly and by being overweight (2). If you try to jump straight into band camp or spring training without having exercised appropriately beforehand, you will put yourself at risk for developing shin splints. Your muscles simply aren't ready to handle 12-hour rehearsal days if you don't prepare for them.
Also, if you come into camp at a higher weight than normal your lower leg will be doing more work than it is capable of. This will put increased stress on the structures in the lower leg and create inflammation that could lead to shin splints.
Wear the Right Shoes
Finally, one of the most powerful ways to prevent shin splints is with the use of proper footwear. In the marching arts setting this is where I have seen the biggest cause of shin splints. Proper footwear is paramount in the prevention of lower leg and ankle injuries. This is especially true for those with flat feet (overpronation)! Make sure you choose shoes that are supportive to your foot and are durable enough to handle the demands of marching.
Marching Health will be releasing a yearly list of the best shoes for DCI and marching arts so keep an eye out for that because shoes are not an area where it is worth being cheap!
Hopefully this gives you a better understanding of what shin splints are, how we treat them, and why we treat them the way we do. Our goal is to keep you healthy and on the field this summer!
1. Shin Splints. (n.d.). Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/shin-splints
2. Newman, Phil et al. “Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis” Open access journal of sports medicine vol. 4 229-41. 13 Nov. 2013, doi:10.2147/OAJSM.S39331