Shin splints are known as medial tibial stress syndrome in the medical profession and refer to widespread tenderness over the bottom 1/3 of the shin bone. This can be more to the front or to the back of the shin. This is as a result of certain muscles (the soleus, tibialis anterior or tibialis posterior muscles) pulling on their attachments on the shin bone (tibia). This pulling on the bone surface results in a local inflammatory response occurring. In mild cases, there is only pain with exercise, but in more severe cases, there can be pain at rest.
Shin splints account for 12%-18% of running injuries and are more common in women. They occur due to internal or external factors, or sometimes as a combination of both.
Internal factors refer to things related to your body: the shape of your feet bones, how flat or arched your feet are, the angle your knees make, weakness in some muscles or tightness in others. In children, is it also related to how quickly their bones are growing in relation to their muscles.
External factors include the type of shoes you are running in, the surface you are running on (soft grass, hard tar, uneven surfaces) and training load (an increase in mileage or speed).
How does physiotherapy help for shin splints?
- Once your physiotherapist has assessed you and understood if your symptoms are actually shin splints and not a different condition with a similar presentation (like a stress fracture or compartment syndrome), he/she will address both the internal and external factors that have led to you developing shin splints.
- Treatment would consist of correction of the muscle imbalances by stretching and strengthening.
- Muscles that normally need to be strengthened are the intrinsic muscles of your foot, that is, the muscles that help lift your foot up and the muscles around your pelvic girdle.
- Muscles that need to be stretched are often the muscles in the back of your leg.
- Therapy will also focus on reducing the inflammation at the site using myofascial release techniques. Sometimes taping/strapping and dry-needling may be used as treatment techniques.
- Your physio will also discuss your training routine and might suggest that you cut back on your mileage and avoid running hills or on uneven surfaces for a period of time. He/she will also look at your running shoes to determine if they are the correct shoe for your foot type or if your shoes need to be replaced.
This article was submitted by Shelagh Shelagh Green Associate Manager at the Woodmead Practice of Lamberti Physiotherapy. Contact her directly to discuss any concerns you may have, or else complete our handy appointment form.
References:
1. Overuse Injuries: Tendinopathies, stress fractures, compartment syndrome and shin splints. RP Wilder, S Sethi – Clinics in Sports medicine, 2004 – kundoc.com