Shin Splints: What you need to know.

Medial Tibial Stress Syndrome (MTSS) or more commonly known as “shin splints” describes pain that is felt below the knee, either on the front, outside part of the leg (anterior shin splints) or behind the inside part of the shin bone (posterior shin splints). Shin splints is a cumulative stress disorder that occurs due to repeated pounding and stress to the bones, muscles, and joints of the lower legs.

Shin splints usually affect people who engage in moderate to heavy physical activity. They are often experienced in beginner runners who do not build their mileage gradually enough or in seasoned runners who abruptly change their workout program, suddenly adding too much mileage or from running on flat surfaces to hills or uneven surfaces.

Identifying symptoms of shin splints

• The pain of shin splints is more generalized than that of a stress fracture.
• Shin splints generally feel worse in the morning because the soft tissue tightens overnight.
• Shin splints are also at their most painful when you forcibly try to lift your foot up at the ankle and flex your foot.

What Causes Shin Splints?

• An anatomical abnormality (such as flat foot syndrome also known as pes planus)
• Muscle weakness in the gluteal region or thigh
• Lack of flexibility
• Poor/improper training techniques

Excessive force on the shins could result from:

• Running on a decline
• Running on a slanted or uneven surface
• Inappropriate running shoes
• Sports that require sudden stops and fast starts

Symptoms include:

• A dull ache in the front part of the lower leg or pain along the inner part of the lower leg
• Pain during exercise
• Muscle pain
• Tenderness or soreness along the inner part of the lower leg
• Occasionally mild swelling in the lower leg (usually not present)
• Numbness and weakness in the feet

Treatment for Shin Splints

Phase 1 – Early Injury Protection: Pain Reduction & Anti-inflammatory Phase

Initial treatment should involve rest, ice and protection as with any inflammatory process.

In the early phase, you may be find it difficult to walk or run without pain, so I recommend you rest from weight-bearing loads.

Ice is a simple and effective modality to reduce your pain and swelling.

Anti-inflammatory medication and natural substances such as arnica may reduce your pain and swelling.

Kinesio-tape will help ensure support to the injured soft tissue and will aid in reducing stress to your shin bone.

Phase 2: Regain Full Range of Motion

During this period, it is important to lengthen and orientate the healing scar tissue by massaging the area, stretching the muscles of the lower leg, neurodynamic mobilisations and specific exercises to ensure full Range of Motion.

Phase 3: Normalise Foot Biomechanics

To prevent recurrence, your foot will be assessed. In some instances, a foot orthotic (shoe insert) may be required or you may have to change your training shoes. This phase will work hand in hand with phase 2.

Phase 4: Restore Muscle Strength

Your calf and shin muscles will need to strengthened to enable a safe resumption of sport or training.

Phase 5: Modified Training Program & Return to Sport

Most shin splints occur due to excessive loads experienced during training. Running sports place enormous forces on your body (contractile and non-contractile).

To prevent a recurrence as you return to sport, you will be guided in your training schedules and exercises to address important components of rehabilitation to help prevent recurrence and to improve performance.

Depending on the demands of your chosen sport, you will require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to your chosen sport.

5 Signs Your Shin Splints Have Healed

1. The injured leg is as flexible as the unaffected leg.
2. The injured leg feels as strong as the unaffected leg.
3. You can push on spots that were painful and no longer are.
4. You can jog, sprint, and jump without pain.
5. X-rays are normal.

There’s no way to say exactly when your shin splints will go away. It depends on what’s causing them. People also heal at different rates. The most important thing is not to rush back into your sport. If you start exercising before your shin splints have healed, you may hurt yourself permanently.

Steps you can take to avoid getting shin splints include:

• Ensure that you are wearing shoes that fit snuggly and offer good support.
• Ensure that your shoes have shock-absorbing insoles.
• Avoid an intense increase in exercise, slanted surfaces or uneven terrain.
• Ensure that you gradually increase the intensity of your training.
• Warm up sufficiently before any work out and incorporate a cool down at the end of training.
• Engage in strength training, specifically those that build calf muscles.
• Avoid exercising through the pain.
• Avoid running barefoot.