What are Shin Splints?
Shin splints, also termed Medial Tibial Stress Syndrome (MTSS), is a common overuse injury characterised by pain on the inside of your shin bone (tibia). The exact mechanism of Shin Splints includes repetitive stress to the fibrous layer of the shin bone (tibial periosteum) and surrounding soft tissues due to excessive or repetitive loading.
Risk factors such as flatfeet, high arch, muscle imbalances, and poor shock absorption may be causes of shin splints.
Shin splints primarily affect the inside of the shin bone. The muscles of the back of the lower leg (e.g., tibialis posterior, soleus) insert into the fibrous layer of the shin. The layer becomes inflamed and irritated due to repetitive stress, leading to shin pain and discomfort.
Who is at risk?
Shin splints are prevalent among athletes, especially runners, dancers, and military personnel.
It accounts for approximately 13-20% of all running-related injuries and affects individuals of all ages and activity levels.
Wearing unsupportive shoes with inadequate arch support will increase the likelihood of developing shin splints as well.
How do I know if I have shin splints (Medial Tibial Stress Syndrome)?
Having shin splints diagnosed requires a primarily clinical approach based on the patient’s history and physical examination.
Symptoms of shin splints include pain along the inside of the shin bone. It typically worsens with activity and improves with rest.
X-rays and MRI may be used to rule out other conditions such as stress fractures or compartment syndrome.
Prognosis
With appropriate management, the prognosis for shin splints is generally favourable. Most cases resolve with conservative treatment measures. Recovery time may vary depending on the severity of the condition and the individual’s response to treatment.
In general, mild cases of shin splints may resolve within a few weeks with proper rest, ice, and over-the-counter pain medications.
However, more severe cases may take several weeks to months of having shin splints treated to fully recover.
RICE principle
One effective nonsurgical treatment for shin splints is adhering to the RICE principle. This is an acronym that stands for Rest, Ice, Compression, and Elevation. This method is particularly beneficial during the initial phase of injury when the pain is most acute.
Rest
It’s important to take a break from activities that worsen the pain of shin splints. This means avoiding high-impact exercises like running or jumping until the pain subsides.
Ice
Applying ice to the affected area helps reduce inflammation and shin pain. An ice pack wrapped in a cloth could be applied to the shin for about 15-20 minutes several times a day, especially after activities that may exacerbate the symptoms.
Compression
Compression bandages or sleeves can help reduce swelling and provide support to the shin muscles. To avoid cutting off circulation, wraps are not to be done too tightly.
Elevation
Elevating the affected leg can also help reduce mild swelling. When resting, try to keep the leg elevated above the level of your heart, such as by propping it up with pillows.
This conservative treatment approach, when applied promptly and correctly, can significantly relieve pain and expedite the healing process for those suffering from shin splints.
Stretching and strengthening exercises
Targeted exercises to improve flexibility, strength, and muscle balance in the lower limb could be prescribed. These improve the condition with the focus on the lower leg muscles and intrinsic foot muscles.
Calf Stretch
Stand facing a wall with your hands against it. Step one foot back and keep it straight, pressing the heel into the ground. Bend the front knee and lean forward until you feel a stretch in the calf of the back leg. Hold for 30 sec to 1 min as tolerated and switch sides.
Towel Stretch
Sit on the floor with your leg extended in front of you. Loop a towel around the ball of one foot and gently pull it towards you until you feel a stretch in your calf. Hold for 30 sec to 1 min as tolerated and switch sides.
Toe Raises
Stand with your feet hip-width apart. Slowly raise your toes up as high as you can while keeping your heels on the ground. Hold for a few seconds, then lower your toes back down. Repeat for 2-3 sets of 10-15 repetitions.
Resistance Band Exercises
Use a resistance band to perform exercises that target the muscles of the lower leg, such as dorsiflexion (lifting off brake) and plantarflexion (stepping on gas) exercises. This helps improve strength and stability in the muscles surrounding the shin.
Biomechanical assessment
Evaluation of gait and lower limb mechanics by physiotherapists to identify and address any underlying biomechanical abnormalities contributing to shin splints (Medial Tibial Stress Syndrome).
Orthotic intervention
Orthotics are specialised devices designed to correct foot posture and distribute pressure more evenly across the foot. This can significantly alleviate the discomfort associated with shin splints. These devices range from over-the-counter insoles to custom-made orthotics prescribed by healthcare professionals.
The goal of orthotic intervention is not only to provide cushioning and support but also to address any structural abnormalities. These include overpronation or supination, that can exacerbate the symptoms.
By improving alignment and function of the foot and ankle, wearing supportive shoes, orthotics and shoe inserts can decrease the repetitive stress placed on the tibia. This reduces the inflammation and pain caused by shin splints.
You could be an athlete looking to enhance your performance without pain or someone who experiences shin splints through daily activities. By incorporating the right orthotic and supportive shoes can be a game-changer in managing this condition effectively.
Gradual return to activity
After employing conservative measures like the RICE protocol and strength exercises to prevent shin splints, a planned gradual return to activity is paramount to avoid re-injury.
This phased approach ensures that the muscles and tendons of the lower leg have sufficiently healed and strengthened, thereby minimising the risk of shin splints recurring.
Begin with low-impact activities such as walking or cycling, and gradually increase the intensity and duration of exercise. This allows the body to adapt without overwhelming the recovering tissues.
Monitoring shin pain levels and adjusting activities accordingly serves as a guide for progression.
This methodical progression aids in complete recovery. It also enhances the resilience of the lower legs against future injuries. Learning the best ways prevent shin splints recurring is also an important part of becoming pain free.
It is crucial for individuals to listen to their bodies and consult with healthcare professionals. They tailor a return-to-activity plan that aligns with their recovery status and fitness goals.
FAQ’s
Is walking good for shin splints (Medial Tibial Stress Syndrome)?
To avoid shin splints, it’s sensible to temporarily stop any lower leg exercises that could worsen the condition, for about one to two weeks. During this period, limit your physical activity to daily routine walking.
Engage in alternative low-impact exercises that don’t make you feel pain, like swimming, using an elliptical trainer, or cycling.
Incorporating these activities can help maintain fitness levels without putting additional stress on your shins.
Why do people get shin splints?
Shin splints are primarily caused by vigorous physical activities. These include intense workouts, competitive sports, or any form of repetitive exertion that puts stress on the lower legs.
Such activities can provoke inflammation in the muscle tissues, tendons, and the periosteum, which is the thin sheath surrounding the tibia. This inflammation is a key contributor to the discomfort and pain commonly associated with developing shin splints.
Understanding the specific triggers and biomechanical factors leading to this condition and sometimes seeking professional help to diagnose shin splints, is crucial for effective prevention and treatment.
Should I push through shin splints?
Taking a rest between physical activities is essential to give your muscles and bones the necessary time to recuperate. It’s vital to listen to your body and use any discomfort or shin pain as an indicator to moderate your activity level.
If you experience the sharp pain of shin splints, it’s advisable to decrease the intensity or frequency of your exercises until the pain subsides.
Trying to endure or “push through” the lower leg pain can exacerbate your condition and prolong recovery time.
Prioritising rest and recovery, along with a gradual return to activity, is key to prevent shin splints effectively and preventing future injuries.
Are shin splints serious?
Shin splints, characterised by discomfort along the inner edge of the shin bone (tibia), can vary in intensity from a mild annoyance to severe pain.
Although these conditions are generally not considered severe, the pain they cause can significantly hinder one’s ability to engage in favourite sports and physical activities.
This condition underscores the importance of understanding shin splints’ triggers and effective management strategies to maintain an active and healthy lifestyle.
Can I just ignore shin splints (Medial Tibial Stress Syndrome)?
Ignoring shin splints can lead to worsening symptoms and prolonged recovery times. This is particularly for individuals frequently engaged in high-impact activities like running, tennis, or basketball.
Common among athletes and fitness enthusiasts, shin splints show as discomfort and pain along the inner edge of the shin bone (tibia), often triggered by repetitive stress on the lower legs.
While shin splints are not typically regarded as a severe condition, they can significantly impede your ability to participate in physical activities and maintain an active lifestyle.
Running through the pain or neglecting proper rest and treatment can exacerbate the issue, underscoring the importance of addressing shin splints promptly and effectively to prevent further complications.
Do compression socks help with shin splints?
Compression socks play a crucial role in managing shin splints by providing targeted pressure that reduces swelling and prevents excess fluid buildup. They are an effective accessory for decreasing discomfort, minimising inflammation, and alleviating symptoms like stiffness and tenderness.
By improving circulation and stabilising the affected area, compression socks offer a dual-action solution— not only do they aid in reducing the immediate pain associated with shin splints, but they also support the overall healing process.
What exercise can you do for shin pain?
To effectively strengthen the lower leg muscles and support shin splint recovery, one beneficial exercise is the heel raise. Begin this exercise by standing with your heels hanging slightly off the edge of a step.
Ensure your legs remain straight throughout the movement. Gradually lift your heels as high as possible, then slowly lower them back down, creating a controlled motion.
Aim to maintain this position for 20 to 30 seconds, repeating the sequence 3 to 5 times.
Shin splint stretches are another way to help to improve painful shin splints.
This exercise routine not only targets the muscles around the shin but also engages the calf muscles, promoting strength and stability in the lower leg area.
If you or someone you know are having any issues with shin splints, or need advice or treatment for other sporting injuries and other problems, give us a call on 0298753760 or book an appointment on our website.
Shin splints are a common injury that we see particularly in runners. The term ‘shin splints’ is used to describe pain along the inside or front edges of the shin. The most common muscles that cause shin splints are tibialis anterior and tibialis posterior. We are now going to look at how to avoid shin splints.
What causes shin splints?
Shin splints are caused by overstraining the muscles where they attach to your shin. The muscles repeatedly pull on the tibia (shin bone), and this excessive loading can result in inflammation and muscle tenderness. The bone may undergo a mild stress reaction, or in more severe cases can develop into a stress fracture. A bone scan or MRI may be required to diagnose the stress fracture.
Shin splints are often associated with poor foot and leg biomechanics, or errors in training load.
Common training errors include
- Increasing your training too quickly
- Running on hard or angled surfaces (like the edge of the road), or uneven ground
- Insufficient rest between runs or workouts
Biomechanics
- Overpronation occurs when the foot rolls inwards too much, flattening the arch of the foot and causing the lower leg to rotate inwards. This increases the stress on the soft tissues of the lower leg.
- Oversupination is where the foot rolls outwards too much, resulting in high arches. If you have high arches you will need lots of supportive cushioning in your shoes.
- Poor flexibility at the ankle joint which can happen after an ankle sprain or fracture
- Tight calf and hamstring muscles
- Poor muscle control
- Weakness in the foot arch muscles
Inappropriate footwear can also predispose you to developing shin splints. Footwear that is old and have lost their support and cushioning can cause injury.
Symptoms of shin splints
So what do shin splints feel like? Shin splints involve dull, aching pain in the front of the lower leg. The pain may be located along either side of the shinbone or in the muscles, and the area may be painful to touch. Symptoms usually develop gradually over time.
Treatment of shin splints
In the initial stages where you are unable to walk or run without pain, you may need to rest from running. Ice can help to reduce swelling and numb the pain. Anti-inflammatory pain medication can be used to help settle the inflammation.
Physiotherapy will involve massage to help relieve your pain and optimise scar tissue healing. We will also prescribe specific stretching and strengthening exercises to ensure optimum rehabilitation. If the cause of your shin splints is due to poor foot biomechanics, you may require a foot orthotic to prevent any future recurrences.
Here at WPH Physio we are able to assess your foot and fit you with orthotics to correct your foot biomechanics. We will also guide you on returning to your sport or running, and advise you on how to slowly build up your training load.
The exercises we prescribe you will be sport specific to ensure you are fully equipped for the demands of your sport or running program.
We will advise you as to whether you require complete rest and if so for how long, if you can do some interval training in the meantime and when it is safe to return to running. We will guide you in a tailored return to running including length of your run, pace, rest periods between runs and gradual increases in volume.
If shin splints are left untreated and you continue with overtraining, they can progress into tibial stress fractures. Therefore it is important to seek treatment early so that you can get back to doing what you love.
How to avoid shin splints
Training load
If you are new to running, you will need to ease into the frequency and duration that you run. Start with no more than 15-20min runs, three times per week. After a couple of weeks at that intensity, you can start to slowly build up by increasing your runs by 5mins each fortnight. For those who are regular runners, you also need to ensure you make gradual changes to your running load.
Footwear
Shoes need to be changed regularly to ensure the foot has adequate support and shock absorption while running. If you are a high volume runner, shoes need to be changed every 6 months. Medium volume runners will need to change their shoes every 8-9 months, while low volume runners should update their footwear yearly.
Orthotics
If you have poor foot biomechanics, foot orthotics are vital in preventing shin splints. When your feet tend to roll inwards (overpronate), you will need an orthotic to provide you with adequate arch support. If you have very high arches you will require lots of cushioning to provide enough support as the foot tends to be more rigid.
Stretching
Perform regular calf stretches before and after running to avoid developing muscle tightness and improve your flexibility.
If you are suffering from shin splints and would like some more information or advice, please give us a call on 9875 3760 or you can book online through our website.
We would be more than happy to help!