Shin Splints – What do I do now?
Shin Splints are one of the most common injuries amongst runners. The term is recognised as pain at the front (anterior) or back (posterior) of the shins.
- Pain at the front of the shins can be due to an overloaded Tibialis Anterior muscle. This muscle is responsible for clearing your foot off the ground when walking or running. If you are having some pain when lifting your feet off the floor with your heel on the ground you likely have Anterior Shin Splints.
- The pain on the medial and posterior part of your shin is generally caused by an overloaded Tibialis Posterior muscle. This muscle controls the inside arch of your foot during weight bearing. A weak Tibialis Posterior muscle can cause a collapsing arch and hence more stress and torsion on the medial shin bone. Pain in this area can lead to posterior shin splints or tibial stress fractures.
- Dull, aching pain at the front of the shins
- Over training the muscles nearest to the shin.
- Over training may be due to too much too soon, poor running mechanics or poor muscle control (feet, gluts, quads, calf, core).
- Poor footwear can also contribute to Shin Splints.
What structures are injured?
- Due to excessive load the muscles (tibialis anterior or posterior) may have tenderness, knots & inflammation.
- Due overload the tendon may become tender to touch – this is the area that is closest to the bone.
- Damage to the bone is generally very tender when touched. The damage is normally at the lower 1/3rd of the shin bone. The bone damage may be mild (stress reaction) or severe (stress fracture). These injuries are best picked up on an MRI or Bone Scan. Only really bad cases will be picked up on a simple X-RAY.
Stages of shin splints
- Discomfort that disappears during warm up (early stage muscle injury)
- Pain that disappears during warm up but reappears during activity (early stage muscle and tendon injury)
- Injury that gets worse during activity (reactive tendon injury, possible stress fracture/reaction)
- Pain or discomfort all the time (Stress fractures)
It is best to consult a physiotherapist for help with any of the stages above. Don’t let yourself slide down the scale. Learn how to best manage and cure shin splints. Physiotherapy will help with allowing enough load through the shins so they don’t react negatively. This is done by getting the weak muscles strong, managing how far to run per week and also what footwear to wear.
Mostly shin splints are not very serious and will get better in a matter of weeks. However, if left untreated and loaded inappropriately they can be serious and require a moon boot (stress fracture)
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By Patrick Mcfadyen