By Laurence Schubert APAM
What is it?
Shin splints are a condition characterised by pain along the inside of the tibia (shin bone). The medical term for shin splints is Medial Tibial Stress Syndrome. The exact pathology of shin splints is unknown, with imaging unable to produce differentiation to someone who does not have the condition. Shin splints have an important relation to two muscles in particular; the Tibialis Posterior and the flexor Digitorum Longus. These muscles both originate from the shin, and attach underneath the foot. The role of these muscles is to extend the foot (plantar flexion) and toes respectively.
What are the symptoms?
Typically, shin splints presents as persistent and aching pain, generally on the inside of the shin, mid way down the leg. This pain may come on during exercise or shortly after you stop, a dull ache may last for up to 12-24 hours. Some people may even experience a sharp pain during exercise that fades quickly.
If the condition is not managed properly then the pain will become progressive. The pain will come on more quickly and eventually the pain will be too severe that it will cause the person to stop the exercise.
What are the causes?
Shin splints are commonly seen in sports that in involve a lot of running or activities that require repetitive weight bearing/impact. This condition is often seen when people change their activity levels too quickly, other risk factors include:
- · High BMI
- · Tight calf muscles
- · Training on hard or uneven surfaces
- · Flat feet
- · Females have increased risk compared to males
- · Prior history of shin splints
How can physiotherapy help?
Identification of main problems and contributing factors will be the important first step. Once this assessment is complete, your physio will begin to address these problems. For example, you may have increased tightness in your calves and decreased foot control. Therefore, a targeted strengthening and stretching program will aim to resolve these factors. A period of rest or activity modification may be recommended, depending on the circumstances.
Activity modification may include reducing running volume and switching to low-impact activities such as swimming and cycling. Once the recovery phase is over, you will work with your physiotherapist to slowly increase your load. This can only be achieved once you have reached certain physical goals, this will reduce the chances of the condition coming back.