What are Shin Splints? How do you Treat it?
Shin splints, also known as medial tibial stress syndrome (MTSS), is a term used to describe pain along the inner edge of the shinbone (tibia). This pain, often referred to as the pain of shin splints, occurs when muscles, tendons, and bone tissue become overworked, often in athletes and those who engage in moderate to heavy physical activity, such as impact sports.
Shin splints are typically caused by repetitive stress on the shinbone and the tissues that connect muscles to the bone. This stress can result in inflammation and small tears in the muscle tissue, leading to discomfort and pain. Common activities that can lead to shin splints include running, especially on hard surfaces or uneven terrain, dancing, military training, and those who cross train.
What are the Symptoms of Shin Splints?
Pain Along the Shinbone: This pain usually occurs along the inner part of the shinbone (tibia) and may be sharp or dull. It might start during an exercise routine but can sometimes become constant.
Tenderness and Soreness: The affected area can be tender to the touch, and there may be soreness before, during, or after physical activities.
Mild Swelling: Some people with shin splints may experience mild swelling in the lower leg. This pain and swelling may be particularly noticeable at certain times a day.
Muscle Stiffness: The muscles around the shinbone might feel stiff or tight. Individuals with flat feet might experience this stiffness more frequently.
Weakness or Numbness: In more severe cases, there might be feelings of weakness or numbness in the feet or lower leg muscles.
Symptoms of shin splints can vary in intensity and may become more pronounced with continued stress or strain on the affected area. If you experience leg pain and suspect you have shin splints, it's advisable to consult with a healthcare provider, such as a physical therapist or sports medicine specialist.
Shin splints account for 10-15% of all running-related injuries for many new runners. They are more common in less experienced runners as their bones may still need to be adapted to the stresses of high-impact activity. Strategies to prevent shin splints include properly pacing your training and ensuring adequate rest.
We see more runners present with shin splints at the clinic at this time of year. Our City to Surf and Half Marathon Runners are simply clocking up their mileage too fast, suddenly increasing their training intensity, or failing to schedule rest days into their programmes.
Like most overuse running injuries, the onset of shin splints is multifactorial and some people are more at risk of developing shin splints than others. They include:
New to running or running history of < 5 years.
High BMI
Females
Prior history of shin splints
Prior use of orthotics
Diagnosing Shin Splints
The diagnosis of shin splints is fairly straight forward. The runner will complain of vague diffuse pain along the bottom third and inside border of their tibia (shin bone). In the early stage this pain reduces when we are warmed up but as the condition progresses and the bone continues to be overloaded (through more frequent training) the pain comes on at an earlier stage. It can be quite painful!
If the runner doesn’t seek treatment and continues to aggravate the shins there is the danger of developing a stress fracture. Even hopping on a single leg 2-3 times will be painful and at this stage we would refer for further investigation (Eg Xray, MRI, Bone Scan).
Treatment
The treatment is multifaceted and some of the key components of the treatment we provide at Limitless for shin splints include:
1. Rule Out other possible causes of shin pain
We aim to rule out other cause of shin pain immediately Eg Stress Fracture, Chronic Exertional Compartment Syndrome
2. Training advice to reduce impact loading:
You may not have to stop training all together but it’s important to avoid activities that cause pain. We will advise you on reducing mileage, intensity and duration of your runs and discuss opting for low impact activities such as swimming and cycling where appropriate.
3. Provide a tailored home programme
We prescribe tailored home strengthening and stretching programmes that address the underlying cause of your shin splints. Exercises in the programme might target a deficit in your hip strength and or a deficit in calf strength, endurance and flexibility, for example.This video below is a home based strength series for running that focuses on the soleus. The calf is extremely important for endurance running. However it is very commonly neglected in terms of both strengthening or stretching.
A post shared by Limitless Physio and Pilates (@limitlessbronte) on Oct 9, 2017 at 11:43pm PDT
Below is a video showing a single leg bridge series of home based strength exercises for running. These exercises are great for strengthening your glutes, improving your pelvic and core stability and if done regularly as part of a balanced program, may help you prevent injury and improve your running performance. ⠀⠀⠀
A post shared by Limitless Physio and Pilates (@limitlessbronte) on Oct 4, 2017 at 11:43pm PDT
4. In-Clinic Running Analysis
We analyse your running technique and may modify your technique. The purpose would be to decrease the impact your tibia has to absorb each time your foot strikes the ground.
5. Provide a return to running programme
We prescribe a return to running programme for the first 4 weeks of return to running after injury.Remember, it can take several weeks to a few months for the tibia to heal however, the earlier you seek advice from a medical professional the better and quicker you return to running.
And finally, the best means of prevention is to progress slowly with both volume and intensity. Try to run on flat, soft surfaces (grass, sand) initially and it is a good idea to continue some softer surface runs to vary your training and decrease the load on your tibia. Arch support may also be beneficial for those with flat feet to prevent further leg pain or shin splints.
Contact the team at Limitless Physio if you feel you have shin pain when you run.
