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  Medial Distal Tibial Syndrome (Shinsplints)

General Guidelines in Treatment of Overuse Injuries in Runners

. Decreasing activity enough to allow symptoms to resolve--alternate day schedule.

. Proper warm up and stretching.

. Ice for 10-15 minutes after activity and as needed.

. Ibuprofen (Motrin, Advil and others) 600-800mg one half hour before running or more frequently if needed

Physical Therapy may be helpful.

Specific Treatment of Shinsplints

Correct hyperpronation

1. Avoid inclined surfaces
2. Choose shoes with the following characteristics:
snug and stiff heel counter
reinforced heel counter helps prevent premature breakdown
built on curve last
good arch support
increased midsole density medially

3. Add medial heel wedge, off the shelf arch support
4. Customized orthotics may be helpful but are expensive.

Reduce shock
. Major Factors:
. Avoid downhills
. Avoid hard surfaces
. Reduce speed
. Choose shoe with adequate cushioning (especially in rear foot for heal strikers, in sole for mid foot strikers)
. Be sure shoes haven't lost their cushioning (midsole often breaks down after a few hundred miles, before other evidence of wear apparent)
. Add visco elastic padding, e.g., Spenco insole

Other Factors:
. Adjust running style (coaching)
. Good muscle flexibility (warm up, stretching)...

from the Physicians at the Los Altos Center
Palo Alto Medical Foundation
370 Distel Circle
Los Altos, CA. 94022
(650-254-5200)

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