What are they? How did I get them? How do I fix them?
Shin splints are a common injury experienced by many runners and sports people. They can be as frustrating as they are painful. Otherwise known as Medial Tibial Stress Syndrome (MTSS), shin splints can be described as pain felt on the inside border of the shin due to overuse or overload.
Any runner will tell you they love to run, and shin splints can be debilitating enough to take away that joy. At Wisdom Physiotherapy Nedlands, we provide evidence-based advice, treatment and management to get you back to running pain-free, with confidence.
Pathophysiology
The shin bone, or tibia, is a major player when it comes to absorbing shock during weight-bearing. The tibia not only absorbs the weight of the body, but is also an anchor point for several hard-working muscles of the lower leg. These muscles pull on the edge of the tibia with every step taken, similar to the way a boat may pull on its mooring with each wave. Bones are dynamic and, under normal circumstances, they adapt to stress and strain by growing thicker and stronger where required. This is a normal physiological process.
However, when the amount of stress overwhelms the capacity for the bone to remodel itself, the new layers of bone are not able to cope with the excessive strain. Where the muscles meet the bone, an area of inflammation arises which results in pain.
Contributing factors
Broadly, the problem is exacerbated by two components: inappropriate training load and muscle imbalance. Shin splints can occur by a sudden return to running, a significant change in the amount of training, a change in the type of terrain or an increase in body weight, whether fat or muscle!
Runners with shin splints will also likely have an imbalance between muscles throughout the lower limbs which contribute to the stress placed on the shin bone.
Research shows additional factors that contribute to MTSS and would need addressing:
- Poor muscular stability at the hips
- Low foot arch / excessive ankle pronation (or rolling-in)
- Foot-slap while running
- Reduced proprioception (sensory feedback from muscles and joints)
Signs & symptoms
- Dull ache along the medial edge of the tibia
- Pain is usually felt on both legs
- Increased pain with heavier landing
- Pain eases during exercise, but returns later
- If severe, pain may persist throughout exercise
- Likely tender to touch along lower two thirds of the medial tibia
- Mild swelling
It’s important to note that other injuries such as stress fracture, compartment syndrome, DVT or a muscle strain may feel similar to MTSS. However, these would require completely different management. Your physiotherapist will be able to differentiate the diagnosis.
How physiotherapy can help
Your physiotherapist will be able to diagnose your condition and answer any questions or concerns you may have. At Wisdom Physiotherapy Nedlands, we assess which factors are contributing to your symptoms and address these using a combination of manual therapy, taping, advice and prescribed home exercises. We also provide Clinical Pilates rehab programs to address muscle imbalances with precise, effective exercises.
At Wisdom Physiotherapy Nedlands, we can design or modify your training program to allow recovery of your shin splints and then progress your running.
