Indications and Contraindications when Diagnosed with MTSS

Training indications and contraindications for when you are injured with shin splints.

Kala Red Light / NIR Therapy Panel with Red Lights Glowing

So, you've been properly diagnosed by a sports medicine doctor and you have shin splints (read: MTSS). Now what?

What can you do?

What are the key training and lifestyle indications while injured with shin splints? Here is a thorough list of activities you can/should do when recovering from shin splints.

Non-impact Cardio

Many people are worried about detraining with regards to their cardiorespiratory fitness. Fear not! There are plenty of fun and easy non-impact cardio training options at your disposal. Many of which help with shin splints as well. Below is a list to get you started:

  • Swimming
  • Biking
  • Assault Bike/Airdyne
  • Elliptical
  • Stair Master
  • Jacobs Ladder
  • Ski-erg
  • Rowing
  • Resistance Training

Remember - anything that allows you to maintain an increased heart rate is cardiovascular training. Don't overcomplicate things. Pick something you find enjoyable that doesn't aggravate your symptoms.

Resistance Training

Most resistance training is still highly recommended. In fact, resistance training is one of the key components of proper recovery and future prevention from an overuse injury such as shin splints.

Photo of ROGUE squat racks in bright red with black ROGUE benches and deadlift platforms.
Resistance training is a critical tool in preventing overuse injuries, stave off aging, and prevent other deleterious health concerns.

The only caveat is to avoid exercises that aggravate your symptoms. This can be movements like heavy squats, deadlifts, etc. It could also be heavy bicep curls if the severity of your injury is bad enough. Pay attention to your body and if you experience discomfort/pain, stop and assess.

Mobility Training

Mobility training often gets lumped into resistance and/or flexibility training. However, you can consider mobility training here as basic movement to enhance blood circulation and movement capability. The idea is simple - move. In the Shin Splints Rehabilitation Protocol there are multiple movements such as ankle and heel rotations, alphabet ankles, dorsiflexion and plantar flexion paired with inversion and eversion and much more.

The purpose behind these rather basic movements is to stimulate blood flow and get you used to your feet and ankles moving in all the directions they are supposed to be capable of. Many people live lives of constant limited range of motion and minimum direction of travel. Plainly put...most people simply move forward in a straight line. Even then, their ankles tend to reach a very limited range of motion. We want to avoid this by introducing fundamental movements to your daily life.

The ability to move in any direction is a core capability of being human. Walk, jog, run, jump, shuffle, bound, strafe, lunge, pivot, turn, step up/down, reverse, etc. are all movements every capable person should be able to do.

Flexibility Training

In other words, stretching. Sedentary lifestyles and limited ranges of motion are two things that contribute a great deal to being tight, stiff, sore, and at risk for injury. Gentle stretching to (not beyond) a full range of motion enables us to move freely and have a much greater resistance to "pulling something", "tearing something", or otherwise damaging our bodies.

Caveat - flexibility and stretching are important. They are core components to healthy movement. However, we are not trying to become contortionists. Stretching should be done in a reasonable and controlled manner, we are not trying to become a rubber band or evoke 100% flexibility over night. This is a gradual process and will take time.

Enhanced Recovery

Enhanced recovery or healing methods, tools, and/or techniques are also recommended if at all possible. Different methods provide different benefits. Some tools enhance blood flow and circulation, some manipulate tissues, some offer pain relief, some provide additional energy or resources required for repairing damage to bone and tissue, and so on.

Recovery Tools/Aids

  • Sleep – as much high-quality sleep as possible.
  • Hydration – water + proper electrolyte intake
  • Nutrition – good quality food (work with a registered sports dietitian if at all possible)
  • Supplementation – this MAY make sense, but you should work with your doctor or like to understand what exactly you actually need to take as this is unique to you
  • Massage – foam rolling, lacrosse ball, massage gun, guasha, etc.
  • Graduated Compression – 2xu or DFND
  • Pneumatic Compression – NORMATEC
  • NIR/IR

Note: These tools aid in healing. They are not prevention tools. There is a big difference between healing an injury and becoming capable again. These tools aid in healing only.

White Lacrosse Ball, KALA Red Light Machine, KEEP Massage Gun, Epsom Salts, Foam Roller, DFND and 2xu Compression Tights.
Recovery tools/aids are strongly recommended during all times of recovery - not just recovery from an injury!

What can't you do?

What are the key training and lifestyle contraindications while injured with shin splints? Here is a thorough list of activities you should avoid when recovering from shin splints.

Excessive Loading

Excessive loading is considered any form of weight-bearing that aggravates symptoms. This could entail anything from simply standing with your full bodyweight on the injured limb(s) to barbell squats or rucking. This will depend entirely on the severity if your injury and stage of recovery.

As symptoms dissipate and your recovery progresses, you will begin increasing load through a variety of activities aimed at strengthening your apparent weaknesses. This reintroduction of loading must be done systematically and tailored to you. As always, listen to your body - if you begin loading too early and symptoms return - stop!

Comments Regarding Weight Loss
If you are overweight, it is imperative that you begin other activities that do not aggravate your symptoms, along with other healthy methods of reducing your bodyweight (i.e., healthy eating, etc.). This will not only assist in your recovery but also help improve your overall health and wellness.

High Impact Activities

Running, jumping, bounding, hopping, depth drops, or any other form of plyometrics should be avoided in the early stages of recovery. Over time, gradual impact training should be reintroduced in an effort to help with bone and tissue tolerance. These activities should be entirely pain free.

When in doubt - KISS (keep it simple, silly). If it aggravates your symptoms - do not do it.

Remember - the road to re-injury is far shorter than the road to recovery. Take care of yourself.