Who else wants to avoid the ‘shin splints’ injury?

The term ‘shin splints’ has become a widely used term in the running community to describe leg pain below the knee. The most common symptoms include a sharp pain that occurs in the lower two thirds of the shin bone during exercise and often turns into a dull ache when resting or with light weight bearing activity.

Did you know there are three different injuries that could be responsible for this pain? If you didn’t, then you are in the right place.

• chronic compartment syndrome
• tibial stress fracture
• medial tibial stress syndrome

This is why a correct assessment is essential to ensure correct diagnosis and treatment of ‘shin splints’.

If left untreated, ‘shin splints’ will affect a runner’s performance and even prevent them from taking part in running events. In severe cases, surgical intervention might even be needed.

Injuries and symptoms causing the ‘shin splint’ syndrome

Chronic compartment syndrome– During physical exercise our muscles expand to allow for increased blood flow to supply the muscles with oxygen. If the connective tissue (fascia) surrounding these muscles fails to expand too, then pressure builds up.

If ignored, the pressure built-up pressure can compromise the muscle’s blood supply overtime, further increasing the intercompartmental pressure.

Symptoms include:

• Lower leg pain during and/or post exercise
• Pins and needles
• Burning sensation
• Cramping that is relieved with rest

This type of injury is mostly likely caused by repetitive use of the calf muscles.

Tibial stress fracture– As a result of repetitive loading, the tibia bone can begin to fracture. This occurs when the body doesn’t receive adequate recovery-time from the trauma of physical activity.

Symptoms include:

• Localised pain to small specific spots at the site of the fracture
• Tenderness on the tibia, which can be relieved with rest
• Deep throbbing pain whilst walking (if left untreated)

This type of injury can be easily distinguished from chronic compartment syndrome and medial tibial stress syndrome because pain is not localised but radiates along the length of the muscle/bone.

Medial tibial stress syndrome– The cause of this type of injury has not been clarified yet, although some researchers suggest that periostitis(inflammation of the connective tissue surrounding bone) could be the trigger.

Symptoms include:

• Pain ranging from a dull aching sensation to sharp pain along the inner side of the tibia bone on weight bearing
• Pain during/after physical activity
• Increased pain on palpation of the tibia bone (particularly the mid-lower two thirds)

This injury is one of the most common amongst runners and symptoms gradually get worse overtime if left untreated.

How to effectively treat the ‘shin splints’

Here are some easy exercises that everyone can include in their schedule to either treat these injuries or help prevent them:

1. Decrease frequency and/or intensity.By simply decreasing the frequency and/or the intensity of your running, the body will spend more time recovering rather than going through the same repeated trauma that caused the injury in the first place.
2. Stretching/foam rollingthe muscles that make up your calves will help relieve overly sensitised tissue muscle tissue.

 

 

Gastrocnemius– stand facing the wall with one foot in front of the other. Keep your back leg straight and feet facing forwards whilst transferring your weight into the front leg by bending your knee. Use the wall for support. You should feel a stretch in the gastrocnemius muscle of the back leg. Hold for 2 minutes and repeat two more times.

 

 Soleus– stand facing the wall with one foot in front of the other. Keep your back leg bent and feet facing forwards whilst transferring your weight into the front leg by bending your knee. Use the wall for support. You should feel a stretch in the soleus muscle of the back leg. Hold for 2 minutes and repeat two more times.

3. Strength work is fundamental before and after an injury, as getting stronger muscles improves the muscles’ tolerance to load. The best strengthening exercises are those that better mimic the discipline the athlete is training for. For a runner, the closest movement that replicates the running movement, is the lunge. Not only does this exercise work all the muscles predominantly used whilst running, but it will improve your single leg strength. This is essential to ensure pelvic stability when transitioning through each stride.

To perform a lunge:

• Take a step forward with one leg
• Bend through the knee of the back leg until your knee touches the floor before pushing back with the front leg
• Ensure you keep an upright torso and maintain a stable base – imagine your feet are on train tracks rather than a tight rope

 

 

4. Increasing load graduallyhelps tackle and prevent shin splints. When training, increase distance and/or intensity gradually whilst still allowing time for recovery. Symptoms of discomfort should be mild and certainly not last until the next day. Remember to be patient with this process!
5. Decreasing the amount ofimpactby increasing cadence and avoiding hills minimise the amount of impact placed on the lower leg.
6. Go and see a professional. At Injury Active, we will carry out a full assessment to identify the cause of ‘shin splints’ (or any other injury). This entails a detailed subjective assessment including training schedule and historical injuries, followed by a full movement assessment as so many factors can trigger an injury (even something as minimal as the foot mechanics, or the vertical displacement can cause shin pain).

Finally, we recommend a course of action that addresses the injury while keeping you active – we do our best to ensure that our clients can train while treating their injury.

If you would like our help, head on over to our website and select the ‘book online’ tab to schedule an appointment at your earliest convenience. Alternatively send us an email and we can arrange to have a meeting via Skype or FaceTime.

Craig Hardingham     – info@injuryactive.com

Jessica Woodhouse  – jessica@injuryactive.com

Olivia Freeman          – olivia@injuryactive.com

Rachael Robinson     – rachael@injuryactive.com

 

Summary & Conclusion

Shin splints is an injury that can be treated non-operatively but should not be overlooked. What is considered to be a non-serious injury can have debilitating effects when ignored. Please feel free to get in touch if you have any questions.

Further information & resources

Media Tibial Stress Syndrome – Pinney & Shaheed (2015)

Medial Tibial Stress Syndrome: Muscles Located at the Site of Pain – Ato Ampomah Brown (2016)

Synopsis of causation – Wilson (2008)

Medial Tibial Stress Syndrome: Evidence-Based Prevention – Craig (2008)