Shin Splints Symptoms – Osteopaths can diagnose, treat and rehabilitate
Following on from our blog on Plantar Fasciitis https://www.holisticbodyworks.com.au/2018/09/24/plantar-fasciitis/, another common complaint encountered by runners is Shin Splints!
So what is Shin Splints?
Shin splints, more formally known as Tibial Stress Syndrome refers to pain felt along the shin bone anywhere between the knee and the ankle. It is said that it is an overuse or over-training injury of the Tibialis muscles as they attach to the shin bone (tibia).
There is micro-bleeding at the junction between the bone cover (periosteum) and muscle origin. This results in widespread inflammation in the shin region therefore causing a severe ache and often swelling.
It is most commonly present in people who play sports that involve running, or people who have increased their exercise load dramatically over a short period of time.
It can present in 2 different ways:
- The Tibialis Anterior muscle attaches along the front or anterior part of the shin bone, it lifts and lowers the foot during walking/running. It causes Anterior Tibial Stress Syndrome with pain felt along the front of the shin.
- The Tibialis Posterior muscle is located behind the shin bone and controls the arch of the foot during the weight-bearing phase of running. It results in Medial Tibial Stress Syndrome with pain felt along the inside of the lower leg.
What are the Signs and symptoms?
- Pain and tenderness are felt along the shinbone usually extending over a length of 10-20cm
- The area is tender and sore to touch.
- The overlying skin may be red and inflamed.
- The pain may be felt during or after running.
What are the risk factors and causes of Shin splints?
- Overuse – exercising too hard or trying to exercise beyond your current level of fitness can strain muscles, tendons, bones and joints. Overuse is one of the most common causes of shin splints.
- Flat (pronated) feet. A decrease in the arch of the foot can result in pulling through the tibialis posterior muscles causing shin splints.
- Incorrect technique whilst running including rolling the feet inwards (pronation), can strain the muscles and tendons.
- High impact activities such as running on hard or uneven surfaces can injure the shin muscles and tendons.
- Running shoes – wearing the wrong type of shoe while running will contribute to shin splints, especially if your feet are naturally pronated.
How your Osteopath can help?
During your initial consultation a history will be taken asking you numerous questions about your complaint in order to determine the causative factor of your pain.
A physical examination will then take place assessing the pelvis and the lower limb. This can include the low back, hips, knees, ankles and feet. This will demonstrate whether there is something further up the chain in the lower limb that could be causing the shin splints.
Initially your osteopath may discuss some management strategies to help relieve your pain.
What is the treatment for Shin Splints?
- Soft tissue massage techniques to the tightened muscles
- Articulation to mobilise any joints in the lower extremity that may be stiff
- Dry needling to release trigger points in the muscle and the fascia (connective tissue)
- Myofascial release work
- Shockwave therapy
- Taping of the feet for support
How is Shin Splints Managed?
- Resting will assist in terms of decreasing inflammation through the tibialis muscles and the periosteum of the tibia therefore decreasing pain.
- Apply an icepack to the affected areas for 10 to 20 minutes, about three or four times daily in order to decrease inflammation.
- Take anti-inflammatories (speak to your Pharmacist before taking to confirm they are safe for you)
- Self massage to help decrease tightness in the tibialis muscles.
- Perform low impact activities while you recover, such as swimming. When returning to running make sure to start off by completing short distances on softer surfaces, such as on grass or on a treadmill rather than harder surfaces such as concrete.
How do I prevent Shin Splints?
- Thoroughly warm up before exercising and make sure to stretch after exercising.
- Strengthen the muscles of your lower legs with specific rehabilitation exercises that your Osteopath will prescribe.
- Reduce the length and intensity of the exercise that originally caused the pain.
- Make sure you wear proper running shoes and replace them before they wear out.
- Take on low-impact activities such as cycling, swimming or walking which will not place as much strain on the lower extremity.
It is important to remember that your osteopath prides themselves on looking at each patient’s case individually. Therefore, they will aim to find the causative factor of your shin splints and prevent it from reoccurring.