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Shin Splints

Shin splintsShin splints is the common name often given to any shin pain at the front of the lower leg. The most common symptoms occur at the front inside of the shin bone and can arise from a number of causes.

Shin splint symptoms

The most obvious symptom of is pain over the inside lower half of the shin bone. There may be pain at the start of exercise which often eases as the session continues only to come back worse later in the training session or afterwards. Pain is often worse the next morning.

Sometimes there may be swelling or lumps and bumps when feeling along the inside of the shin bone. Pain may also be triggered when the toes or foot are bent downward. Occasionally in severe cases a red inflammation over the inside of the shin may be seen.

Shin splints explained

Shin splintsUnderstanding what causes shin splints can help rehabilitation and prevention. One of the most common causes is inflammation of the periostium of the tibia or sheath surrounding the bone. Traction forces on the periosteum from the muscles of the lower leg cause pain and inflammation. This has lead to the use of terms such as medial tibial traction periostitis.

Shin splints can be caused by a number of biomechanical factors as well as errors in training. Overpronation of the feet where the foot rolls inwards too much flattening the arch of the foot and causing the lower leg to rotate inwards. Over supination of the feet where the foot rolls outwards too much during the time the foot is in contact with the ground.

Over pronationInadequate footwear which includes the wrong type of shoe for your running style as well as using running shoes that are just too old and have lost their support and cushioning can cause shin splints. Increasing training too quickly, running on hard surfaces, on your toes as in sprinting and generally doing too much too soon can increase the risk of injury and shin pain.

Decreased flexibility at the ankle which causes increased stress on the soft tissues, muscles and tendons of the lower leg.

Treatment

Treatment for shin splints involves reducing pain and inflammation, identifying and correcting training and biomechanical problems and restoring muscles to their original condition.

What can the athlete do?

Shin tapingRest to allow the injury to heal. Avoid activities which make symptoms worse such as running and jumping but try to maintain fitness with other non weight bearing exercises such as swimming, cycling or running in water. Shin splints taping can is excellent for supporting the muscles and reducing pain instantly.

Apply ice or cold therapy in the early stages, particularly when it is very painful. Cold therapy reduces pain and inflammation. This can be done for 10 minutes every hour for the first few hours then at least 4 times a day after. See our Rehab program for more details.

Stretching exercises should be done to stretch the muscles of the lower leg. In particular calf stretching exercises which will stretch the tibialis posterior muscle which is associated with shin splints.

Cold packWearing shock absorbing insoles in shoes particularly if you run or walk on hard surfaces in poorly cushioned shoes will help reduce the shock on the lower leg.

Apply heat and use a heat retainer or shin and calf support after the initial acute stage and particularly during training. This can provide support and compression to the lower leg helping to reduce the strain on the muscles. It will also retain the natural heat which causes blood vessels to dilate and increases the flow of blood to the tissues to aid healing

Exercises may help prevent shin splints from returning in the long run by strengthening the muscles of the lower leg.

What can a sports injury clinic or doctor do?

Shin splints supportPrescribe anti-inflammatory medication e.g. ibuprofen (always consult a doctor before taking medication). This will reduce pain and inflammation.

Taping will allow the shin to rest properly by taking the pressure off the muscle attachment. Once you have been taught to apply tape this is something you can do yourself regularly until pain has gone.

A podiatrist can perform gait analysis to determine if you overpronate or oversupinate and prescribe orthotic inserts to correct any biomechanical problems.

Sports massage techniques to the posterior deep muscle compartment can help but avoid the inflamed periostium close to the bone. Massage can help relax and stretch the tight calf muscles taking strain off the inflamed and painful tissues. If all conservative treatment fails then surgery is an option, although this is rare.

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