As physio’s we frequently see people with injuries that have arisen after increasing the intensity of their exercise routine. Often these injuries are not from one specific incident, rather they present as a slow onset of pain gradually worsening over time.
One of these common presentations are shin splints, also known as medial tibial stress syndrome.
So, what are shin splints?
Shin splints are an overuse injury of the structures that attach to the inside of the tibia (shin), often causing inflammation and pain. Shin splints will present as pain along the inside of the shin bone, which may be a dull ache or sharp pain. The intensity of the pain can greatly vary, however, it will almost always be aggravated by physical activity. This may mean the pain only presents during higher load activities such as running and jumping, or if the injury is particularly irritable, it may present with simply walking. Aching in the shins after the activity is also quite common.
Research has shown that there are multiple factors that contribute to overuse of the anterior structures of the lower leg leading to shin splints. Most commonly it arises after an increase in physical activity which your muscles (particularly the calf and gluteals) don’t have the strength to sustain, and therefore your shin muscles are overworked leading to a build up of tension and inflammation. Although it is often seen in runners who increase their training too quickly, we also see this in people who decide to simply increase their walking distances or take up a new hobby such as dancing or sport.
Importantly, we often see people with recurring injury, where they will rest, allow the pain to resolve, go back to exercise and the shin pain comes back again. There are multiple reasons for this, some including:
- Weakness in the whole leg, particularly the calf, quadriceps and gluteals, which leads to overuse of the muscles in the front of the shin.
- Foot pronation (feet rolling in or issues with the foot arch).
- Foot wear lacking in support and shock absorption.
- Poor hip control causing increased load through the lower leg.
- Reduced ankle and foot flexibility.
- Running technique.
- Exercising on a hard surface.
How can Physiotherapy help?
- Physiotherapy will not only aim to resolve the current injury, but to prevent it from returning again.
- Your Physiotherapist will do a thorough assessment to make a diagnosis and then identify what factors have lead to the shin splints.
- Your Physiotherapist will take the time to talk to you about your current exercise routine, how this needs to be altered to allow the appropriate healing to occur and then how it will be progressed back to the level of activity that you are aiming for.
- Common interventions include:
- Massage, manual therapy and dry needling to reduce muscle tension and help to correct leg and foot positioning.
- Strengthening and stretching exercises.
- Running retraining.
- If necessary, you’re Physiotherapist may refer to a Podiatrist for innersoles to assist in your foot mechanics.
Whether you’ve been battling with anterior shin pain on and off for a long time, or you’ve just started experiencing it for the first time, Physiotherapy can address the problem now and then provide you with the tools to stop it from returning.
By Sophie Oud