With the days getting lighter and weather hopefully improving you may feel it is time to get out there and start getting fit for summer, or even train for a run or multi-sport event. However, a sudden increase in activity if not taken carefully, can lead to injuries. Shin Splints is a common usage term for pain felt along the inner or outer border of the tibia (the shin bone).
Is Shin Splints an Injury or Symptom?
Technically speaking (from a Physiotherapy point of view) it is not a diagnosis, it only describes the symptoms and not the actual cause of the problem. The cause is inflammation or irritation to the muscles and sometimes the bone where the muscles attach. If it is not managed appropriately it can lead to more serious problems such as a stress reaction (damage to the outer layer of bone), a stress fracture (damage through the bone) or compartment syndromes (swelling of the muscles).
Causes of Shin Splints
The cause of both Anterior and Posterior Shin Splints is usually due to an overuse of the muscles that attaches to the shin bone. They have, however, different reasons for developing.
Anterior (outer) shin splints affect the muscles in the outer aspect of the front of the shin. This type of shin splints is commonly seen when running is started on a hard surface, either the footpaths as winter finishes or the hard fields during preseason training in the New Year.
The cause is thought to be the repetitive jarring as the foot strikes the hard ground. This is made worse by weak muscles at the front of the leg which lower the foot to the ground, tight calf muscles and poor biomechanics e.g. flat feet. If your running sounds loud as your foot strikes the ground you may be prone to this type of shin splints.
The main symptom of anterior shin splints is pain along the front and outside of the shin. Initially this pain will only come on towards the end of a run but as it gets worse it will become more frequent and start earlier. In some cases it may be there even with just walking. The muscles will often become sore to the touch.
Treatment includes modifying your training intensity, ice massage, stretching your calves and strengthening you front shin muscles. Your physiotherapist can give you advice on how to do these. The symptoms can also be helped by using ice massages after activity.
Posterior (inner) shin splints affect the muscles in the back and inner part of the shin. This type is more commonly seen through the whole year, but is often brought on during a sports tournament situation, where an athlete plays multiple games within a short timeframe, or a noticeable increase in training load as in the later training stages for an endurance run or multisport event. Poor or old footwear (lack of arch support) is often a factor. Posterior shin splints are more due to biomechanical problems (how we move) and muscle weakness. Unsupported arches and weak hip muscles result in the knee rolling into the middle of the body resulting in a jarring and over stretching of the muscle.
The pain produced by this type of shin splint usually starts along the inside of the lower leg, and worsens when a runner rises up on the toes or rolls the ankle in, especially landing from a jump or step. Progression is similar to Anterior Shin Splints with increasing pain and local tenderness.
Treatment of Shin Splints
The goal of treatment must be in a few phases dependent on the severity of symptoms that are being felt and this is often linked to the duration of symptoms.
For Acute onset of shin splints, sometimes its just managing your load of work done, so some rest, some modification of your training and then making sure that your running technique, especially as your foot strikes the ground is suitable. If you strike the ground and rotate your knee or lower leg inwards, sometimes this can be a factor in developing shin splints, so this is where seeing someone such as a Physiotherapist, or an Exercise Physiologist or Strength and Conditioning Coach with specific experience in running biomechanics is going to be useful.
For ongoing shin splints and recurring shin splints, modifying training load again is an important factor in recovery. Sometimes a Podiatrist will play a role here, in helping with Arch supports, through either orthotics or short term strapping can help the early stages, and also when returning to full activity. Ice massage of the affected area can also be effective short term.
Specific Exercises to strengthen the injured or weak muscles and to learn how to control your body when your feet strike the ground are VERY important.
Does Strength Training have a role in running?
A side issue on this article. Strength training for running is sometimes seen as “boring”. It is generally an easier session if you are out running or doing sport, so sometimes working on your balance, doing single leg squats and Glute exercises are not very exciting! But, its all about your commitment to a long-term plan, rather than the next 10 weeks, think about 10 years in front of you!
Strength training depends for each person in my opinion. Some runners are just not psychologically built to “do strength training” in the traditional sense, so we need to make it more challenging and focused on something that they will do.
The old adage, that I was taught was that a great program is pretty useless if the athlete does not do it! So, sometimes modification of activity and doing things that strike an interest chord with someone that still works on the same concept is just as good.
I would just say that as long as you think about HOW you do what you do, then thats the main approach with training to prevent an injury or treat an injury like shin splints.
A practical view of some of the issues that we see in patients with shin splints
Some causes and factors in developing Shin Splints
SHIN SPLINTS!! If you have ever had a problem with shin splints or know someone that does, you would know it’s quite a painful and frustrating injury. Head Coach Glenn Hansen talks here about some of the common factors or causes that we see when we are working with athletes with shin splints. If you have any of these common causes or are concerned, you are welcome to contact Vector Health & Performance on 4927 8190 or via direct message so we can help you either avoid this frustating condition or to correct some of the mechanical issues that can help in causing shin splints.
Posted by Vector Health on Thursday, 15 March 2018
If I have have shin splints, what should I do?
You can book an appointment to come and see Hamish, our Senior Physiotherapist, or Glenn Hansen, Head Coach at Vector Health and Performance. By Phone 4927 8190 or you are welcome to email glenn@vectorhealth.stagingarea.net and we can organise a time to catch up and get a program started.