What are Shin Splints and what causes them?
Shin splints are typically exercise related pain on the inside of the shin bone (i.e. tibia).
They are typically caused due to increased stress along the inside of the shin bone usually during walking and/or running. Commonly, the muscles and tendons that run down the inside of the shin are having to work too hard. This loading causes chronic traction on the outside of the bone (i.e. periosteum) resulting in shin pain. It is important that your Physiotherapist assesses and identifies what is causing this. For example; the following are a list of risk factors that contribute to the onset of shin splints:
- Female gender
- Running kinematics and less years running experience
- Excessive rolling in of the feet (i.e. flat feet)
- Increased hip rotation
- Increase Body Mass Index (BMI)
- Muscle overuse or chronic fatigue
- A bony overload injury
- Reduce calf size
- Previous history of shin splints or tibia stress fracture (Moen et al., 2009; Newman et al., 2013)
Other factors that need to be considered would be training load, shoe design, previous use of orthotics, training surfaces, ankle range of motion, and lower limb strength.
Symptoms of Shin Splints
Severity of shin splints can vary depending on how long you have had the pain and the area of pain. Often shin splint pain decreases once warming up, allowing completion of the training session but progressively the pain occurs during activity. In more severe cases, it will be painful to walk down stairs, hurt overnight and be worse the following day after exercise.
Treatment and Physiotherapy
Prior to any treatment it is important a Physiotherapist accurately diagnoses the shin pain and arranges imaging if indicated.
Effective treatment needs to address the primary cause of the shin pain, rather than just treating the symptoms. Finding out what factors are causing the tendons and bone to be painful is what will give long term improvement.
Often, treatment starts with relative rest, ice and pain relief as required. It is important that pain free cross training is still performed as it is important fitness is maintained (Moen et al., 2009). It is also important that a graded return to running and activity is also followed. Once the underlying factors have been identified Physiotherapy may include:
- Shock absorbing footwear and insoles
- Taping techniques to address foot biomechanics
- Soft tissue techniques
- Dry needling techniques
- Running and walking analysis and correction
- Foot and ankle joint mobilisations
- Hip, knee, ankle and foot muscle strengthening exercises
- Ankle and foot range of motion exercises
To see a Physio at Restore Function Physiotherapy & Pilates before symptoms get worse…
Shin splints are not a condition you should ignore, keep pushing through the pain or hope that they will go away. This is due to the potential of the bone getting damaged, resulting in bone stress or a stress fracture. This injury requires long periods of rest and often wearing a moon boot to allow the bone to heal. Compartment syndrome is another diagnosis of shin pain. It is characterised by exercise related pain, with or without neurological symptoms and usually occurs more over the soft tissues. If you are experiencing shin pain it is important to have it accurately diagnosed so the most appropriate treatment can start.
References
Moen, M et al. (2009). Medial tibial stress syndrome: a critical review. Sports Medicine, 39 (7) pp 523-546.
Newman, P et al. (2013). Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Journal of Sports Medicine, 13 (4) pp229-241z
