Shin splints is a ‘catch all’ term used to describe a common overuse injury that causes pain on the inside part of the shin bone (tibia). People with shin splints often place large amounts of repetitive weight bearing loads through their shin bone, generally through a change in routine. This condition is most common with endurance athletes like long distance runners. The most common symptoms of Shin splints are:
- Pain along the inside art your lower leg or shin bone.
- Tenderness to touch over the inner part of the shin bone.
- Pain may be sharper with activity and become more diffuse or completely pain free with relative rest from weight bearing high impact activities.
- Pain can often occur in both shins.
- Pain usually begins as on and off discomfort with high impact activity for example pain whilst running which settles shortly afterwards. In more severe cases the pain can become more constant.
What Causes Shin splints?
Shin splints is caused by repetitive running or jumping activities that place more stress on the muscles and inside part of the shin bone than it can comfortably withstand. This may be from inflammation around the connective tissue of the shin bone or where the tendons attaching to this area are put under too much stress leading to microtrauma. When the bone does not have adequate recovery time to heal the damage can build up and get worse.
Anyone can get shin splints however it is much more common for certain groups to develop this condition. Groups that are at higher risk of developing shin splints include:
- Runners, especially runners that have increased their training load suddenly or started running on unfamiliar terrain e.g. beach running.
- Athletes that play high impact sports e.g. Football, Netball, dancing.
- Individuals with osteopenia or osteoporosis means the tibia bone will be more prone to this condition.
- People with flat feet or very high rigid arches, this can amplify the ground reaction force going through your shin bone.
- Anyone with underlying vitamin D deficiency, eating disorders or loss of normal menses.
How does Physiotherapy help treat shin splints?
The most important aspect to successfully treating your shin splints is getting an accurate diagnosis from an expertly trained health professional. There are many other conditions that can masquerade as shin splints including stress fractures, compartmental syndrome and even referred lower back pain. Here at Fixio we have seen this condition many times and can quickly arrive at an accurate diagnosis and begin an individualised treatment plan during your first session. Physiotherapy treatment for shin splints can be thought of in two distinct stages.
Stage one involves reducing the pain in your shin bone. This is achieved offloading the inside part of your shin bone. We will also utilise every trick in our physio playbook to help reduce your symptoms such as:
- Relative rest: We may ask you to take a break from certain high impact activities that flare up your condition. This does not mean that have to forgo all exercise, we can advise you on the best cross training activities for you. Generally swimming and bike riding can be great low impact activities to maintain your conditioning.
- Ice, applying a cold compress ice pack to your shins for 20 minutes three to five times per day especially after exercise can help reduce pain and any swelling especially during the early stages of your condition.
- Pain relievers ( In conjunction with your G.P.).
- Dry needling (link) for pain relief.
- Soft tissue massage over the Soleus, gastrocnemius and tibialis posterior muscles.
Once we have the pain under control we can begin to build up your shin bones ability to withstand stress by an incremental strengthening and flexibility program. During this stage we will also rectify any underlying biomechanical risk factors you might have. Treatment during this stage may include
- Eccentric calf strengthening exercises.
- Strengthening all major muscle groups of the lower limb and core exercises to improve overall strength and movement mechanics.
- Proprioceptive balance training to improve landing stability when running and jumping especially designed to help when exercising on uneven surfaces.
- Advice regarding the best running shoes for your foot arch or heel wedge raises and advice regarding the need for orthotics.
So don’t let shin splints be an excuse for not doing what you love. Come in and get it sorted once and for all.