Explanation of Diagnosis

Shin splints occur when the muscles, tendons, and bone tissue in the shin (tibia) become inflamed due to overuse, repetitive stress, or improper biomechanics. They are common in runners, dancers, and athletes who engage in high-impact activities. Symptoms include aching or sharp pain along the inner shin, tenderness, and swelling, especially during or after activity. If untreated, shin splints can lead to stress fractures.

Specific Work Modifications

• Avoid prolonged standing or walking on hard surfaces.
• Wear cushioned, supportive shoes with shock-absorbing insoles.
• Use anti-fatigue mats if standing for long periods.
• Take sitting breaks and elevate legs to reduce swelling.
• Apply ice after work if pain or swelling increases.

Specific Activity Modifications

• Avoid high-impact activities (e.g., running, jumping, dancing) until pain resolves.
• Modify workouts by switching to low-impact exercises like swimming, cycling, or elliptical training.
• Wear proper footwear with arch support during activities.
• Stretch and strengthen lower leg muscles before and after exercise.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports tendon and bone healing.
• Vitamin D3 (1000-2000 IU daily) – Enhances bone strength.
• Calcium (1000-1200 mg daily) – Supports bone health.
• Magnesium (300-400 mg daily) – Helps with muscle relaxation and cramping.
• Omega-3 fatty acids (1000 mg daily) – Reduces inflammation and pain.

Recommended Nutrition and Hydration

Diet Recommendations:

• Bone-supporting foods: Dairy, leafy greens, almonds, salmon, and fortified cereals.
• Anti-inflammatory foods: Fatty fish, turmeric, berries, and walnuts.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support tissue repair.
• Limit processed foods, excess sugar, and soda, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to support muscle and bone health.
• Limit caffeine and alcohol, which can dehydrate tissues and slow recovery.

Home Exercise Prescription

Perform 2-3 times daily to relieve pain and strengthen the lower leg:

Phase 1: Pain Reduction & Mobility (Days 1-7)

1. Ice Massage

1. • Use a frozen water bottle or ice cup to massage the shin for 10-15 minutes after activity.

2. Calf Stretch (Straight & Bent Knee)

1. • Stand facing a wall, place one foot back, and keep the heel on the ground.
   • Hold for 20-30 seconds, repeat 3 times per leg.

3. Ankle Alphabet Exercise

1. • Use your toes to "write" the alphabet in the air.
   • 1-2 times daily.

Phase 2: Strength & Prevention (After Pain Improves, 1-2 Weeks In)

4. Toe Raises (Tibialis Strengthening)

1. • Stand with feet flat and lift toes off the ground.
   • 10 reps, 2 times daily.

5. Heel Raises (Calf Strengthening)

1. • Stand and slowly raise onto your toes, then lower.
   • 10 reps, 2 times daily.

6. Resistance Band Dorsiflexion

1. • Secure a resistance band around your foot and pull toes upward against resistance.
   • 10 reps per foot, 2-3 times daily.

Phase 3: Return to Activity (Once Pain is Minimal, 3+ Weeks In)

7. Single-Leg Balance Exercise

1. • Stand on one foot for 15-30 seconds, increasing time as tolerated.
   • Repeat 2-3 times per leg.

8. Forefoot Running Drills (Gradual Return to Running)

1. • Perform short, controlled running drills on soft surfaces before full return to sport.

⚠ Avoid running on hard surfaces, jumping, or sprinting until fully healed (typically 4-6 weeks).

Helpful Books

1. "Rehab Science: How to Overcome Pain and Heal from Injury" – Tom Walters, DPT
2. "The Healthy Runner's Handbook: Injury Prevention & Recovery" – Jason Karp, PhD

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.