Management & Rehabilitation Protocol

In order to complete the stretches and exercises of this rehab at home, the only equipment you need are stairs, walls, & a towel. 

Stretches - 4×/Day, 30 seconds each - Typically, wake-up, before practice, after practice, before sleep

• Gastrocnemius: https://youtu.be/f1HzSAuB-Vw

• Medial Gastrocnemius & Flexors (Same as Gastrocnemius stretch, rotate foot in 45 degrees)

• Lateral Gastrocnemius & Peroneals (Same as Gastrocnemius stretch, rotate foot out 45 degrees)

• Soleus: https://youtu.be/J0jgWqbBR2E

Ice Cup Massage - 1×/Day - Typically, after post-practice stretching, if necessary

• Massage painful areas for 5-10 minutes, constantly moving the ice: https://youtu.be/hZOfP9cwGbk

Stage 0 Exercise Circuit - 2×/Day (Typically in the morning and at night) - Complete with every stage

• Eccentric Calf Raises 2×30 repetitions each leg, complete on a stair while holding on to a railing: https://youtu.be/gEgx0qJp3HM

• Toe Raise 2×15: https://youtu.be/gRHg6v6-szc

• Towel Scrunches 2×5: https://youtu.be/XEJYq1HBtHY

Stage 1 Exercise Circuit - 2×/Day - If experiencing pain while fully weight-bearing completing activities of daily life and not participating in practices or competitions

• Seated Calf Raise 2×15: https://youtu.be/3ZRe_QpvRPg (No weight)

• Seated Rotate-In Calf Raise 2×15 (Same as first, rotate foot in 45 degrees)

• Seated Rotate-Out Calf Raise 2×15 (Same as first, rotate foot out 45 degrees)

Stage 2 Exercise Circuit - 2×/Day - If pain-free while fully weight-bearing completing activities of daily life and participating in a modified capacity (pain-limiting activity)

• Standing Calf Raise 2×15: https://youtu.be/UV8gOrHmuKc

• Rotate-In Standing Calf Raise 2×15 (Same as first, rotate foot in 45 degrees)

• Rotate-Out Standing Calf Raise 2×15 (Same as first, rotate foot out 45 degrees)

• Bent Knee Standing Calf Raise 2×15: https://youtu.be/vpgeEpfMLw8

• Eccentric Calf Raises 2×30 repetitions each leg, complete on a stair while holding on to a railing: https://youtu.be/gEgx0qJp3HM

Stage 3 Exercise Circuit - 2×/Day - If pain-free while fully weight-bearing completing activities of daily life and participating in practices or competitions

• Single Leg Standing Calf Raise 2×15 each side: https://youtu.be/QEILIo9Kzlw

• Single Leg Rotate-In Standing Calf Raise 2×15 each side: (Same as first, rotate foot in 45 degrees)

• Single Leg Rotate-Out Standing Calf Raise 2×15 each side: (Same as first, rotate foot out 45 degrees)

• Single Leg Bent Knee Standing Calf Raise 2×15 each side: https://youtu.be/_VEku5gTQeU

• Single Leg Balance 2×15 sec (or as long as possible) each side: https://youtu.be/ZLxyh_PEstI

Additional Body Weight Exercises - 1×/Day - Add in once mostly Pain-Free while jogging at a 50% pace

• Body Weight Split Squats 3×15 each side: https://youtu.be/UcZVX7Sc9YI 

• Single-Leg Glute Bridge 3×15 each side: https://youtu.be/3NXv0Nany-Q

• Alternating Leg Raise 3×15 each side: https://youtu.be/gB9bRfuk8no 

Tips for Prevention

Here are five helpful pieces of advice for you to prevent developing shin splints while being an athlete:

1. Buy new athletic shoes that are right for you – Ill-fitting shoes or shoes that lack proper features can contribute to shin splints. Depending on your activity, you may need to replace shoes often. It’s a great idea to have several pairs of good athletic shoes, and regularly rotate the pair you use. Local retailers, like Marathon Sports, can provide great advice for the right shoe for you.

2. Exercise with less impact whenever possible – Exercising on harder surfaces, such as roads and sidewalks, increases the amount of force that your bones and muscles must absorb. This causes muscle fatigue and overuse, and ultimately, shin splints. In addition, if ever possible, team conditioning on a turf or grass field should be done in running shoes. This decreases the impact of conditioning compared to cleats, as cleats offer little to no cushion in their design. 

3. Stretch and strengthen your legs and core – Stretching and strengthening key areas of the body can both prevent tight muscles that can lead to shin splints and keep the body strong enough to absorb more of the shock and pressure on the leg during exercise. 

4. Avoid sudden increases in physical activity – Gradually increase activities such as running, jumping, and walking. This includes spreading out days between activities and/or doing alternate forms of exercise.

5. Stay at a healthy body weight – Increased body weight can put more force through the lower legs when exercising which can lead to a higher risk for shin splints. 

Facts

Here are Five Facts about "Medial Tibial Stress Syndrome" or "Shin Splints":

1. Shin Splints are typically felt in the distal third of the medial aspect of the tibial shaft - An athlete with a case of shin splints usually feels pain along the inside border of the shin bone.

2. Most cases of Shin Splints can be treated in-house - Speaking with your athletic trainer about pain in your shins is the first step to overcoming Shin Splints and not missing any time in participation.

3. Athletes with High Arches & Flat Feet are more at risk for Shin Splints - Athletes with High Arches & Flat Feet tend to put high stress through their shins and develop shin splints.

4. If left untreated, it is likely Shin Splints can develop into a "Bone Stress Injury" or "Stress Fracture" - Without an intervention or change in the activity of an athlete, the repeated stress causing the Shin Splints will develop a Bone Stress Injury.

5. Evidence of Shin Splints will not show up on an X-ray - Until a case of shin splints develops into a stress fracture, it will likely not appear on an X-ray.