Even if it hurts, don’t scream and shout, instead work out. That’s the latest mantra in the fitness world. Says Jayanti Bhatia, a Calcutta-based 22-year-old software executive and a fitness freak, “If it’s hurting ? in the shin, chin or spine ? don’t whine, but get rid of it by doing another aggressive session the next day.” Jayanti is unaware that misplaced determination could actually cause more harm than good. Especially, if you are a victim of shin splints. Also known as medial tibial stress syndrome, shin splints are an exercise-related pain caused by the overuse of legs. Such pain can be extreme and could even prevent you from continuing with your workouts. Spanning about three to four inches, the pain might recur if you start exercising before the injury actually heals.

With a steep rise in the number of people hitting the gym, the number of people suffering from this condition has gone up; more so because of the rigorous sessions some of them indulge in, without the guidance of a physical trainer. Explains Kiran Sawhney, Delhi-based wellness trainer, “Shin splint is the lay term used to describe symptomatic pain caused by an inflammation of the muscles or tendons in front of the shin. It can be so bad that the muscles can be damaged, tendons torn and even splinters of bone pulled free. It affects your two leg bones: the tibia and the fibula, and develops when the muscles attached to these bones get inflamed, causing intense pain.”

Shin splints are also common among aggressive walkers, those involved in high-impact sporting activities and especially those with flat feet. Says Dr Samir Gupta, a Calcutta-based orthopaedic surgeon, “Usually, flat-footed people are vulnerable to shin splints. This is because there’s a pooling of blood in the legs and the venous return through the peripheral veins gets hampered. So the blood tends to move proximally through the venous pathways within the bone. Consequently, the venous pressure in the bone increases, causing severe pain in the shin.”

Inexperienced runners and aerobic dancers are also vulnerable to such injuries. In the case of runners, shin splints result when the anterior leg muscles are stressed. The condition is further aggravated if one runs on a hard surface such as concrete. The harder the surface, the greater the shock wave. That’s because the pain in the lower legs is caused by the stress on the bones or on the muscles in that region, notably the tibialis anterior. These muscles are partly responsible for the up-and-down movements of the foot at the ankle joint.

Says Gautam Deb, senior fitness trainer, Addlife Gym & Health Spa in Calcutta, “In aerobic dance, for instance, there is a fair amount of movement at the ankle joints. Such activities involve considerable vertical movements which cause further stress on the muscles.” The muscles can absorb only a certain amount of shock and the rest is transferred to the bones, leading to their stress fracture. So in the initial stages, the ‘shins’ (actually the muscles) pain and even restrict movements.

There are two different ways of handling a shin splint problem. The first involves total rest and the second is a run-through-it approach. Total rest is often unpopular with amateur athletes for whom regular practice is part of developing and mastering professional running skills. The latter ? the run-through-it approach ? is worse, because it aggravates the injury. Currently, a multifaceted approach of “relative rest” ? including elements such as specific workouts that enhance one’s cardiovascular fitness and anti-inflammatory medications, among other things ? is gaining popularity.

Sawhney, however, advises an initial treatment that involves the RICE principle: rest, ice, compression and elevation. “To avoid future shin splints, you must warm up your muscles before and after any physical fitness activity including walking,” she emphasises, adding, “take special care to stretch the calf muscles; wear walking and exercise shoes with a good fit and proper support. You must especially use insoles and other shoe inserts to reduce the stress placed on muscles and tendons on the front and sides of the legs. To strengthen the tibialis anterior muscle, you can perform toe tapping or place a weight on the top of the foot and pull the foot up repeatedly.”

So the next time you have a searing pain in your lower leg, you know what to do.

Keep your feet in good health

• Warm up the muscles by doing 20-25 reps of calf raises by standing on your toes and going down to normal position. Along with this, do 20 to 25 reps of shin flexions by moving the foot towards your shins and then away.

• Do strengthening exercises to develop these muscles ? particularly the tibialis anterior (front lower legs), and the gastrocnemius and soleus (rear lower legs).

• Wear appropriate shoes. If you are practising ballet, wear shoes that are meant for ballet ? glove-like soft shoes with extremely flexible soles. If you’re into aerobics, get yourself a pair of cushioned cross-trainers. For road running, wear shoes with flexible toes and thick cushioned heels. Remember, worn out shoes lose their shock absorbing capacity. Replace them immediately.

• Ensure that you are not overweight, as excess weight will add to the stress on the shins.

• Keep your muscles hydrated. Make sure you drink a lot of water and fluids.

• A good massage is also helpful.

• Start exercising/ walking/ running or doing aerobics in a gradual manner: Do not overdo it on the first day itself.

pain killers

• Rest: Considered to be the most convenient as well as immediate treatment

• Ice: If applied immediately after exercise, it lessens the pain and inflammation

• Switch mode: Non-weight bearing exercises such as swimming or bike riding are beneficial

• Stretches: Stretching your calf muscles and Achilles’ Tendon every day can be of help

• Massage: In many cases, wrapping your lower leg with a bandage or special sleeve may help treat shin splints.