Have you ever been exercising and noticed pain along the front of your lower leg?
Medial Tibial Stress Syndrome or “shin splints” describes pain felt along the shinbone and is a common presentation that runners, dancers or people doing other high impact activity e.g. basketball can suffer.
This pain is caused by inflammatory process around the front of the lower leg due to repetitive stress or load of the muscles and tendons that attach to the lower leg bone (Tibia).
The Anatomy
There are many muscles around the front, back and side of your lower limb which all work together to create optimal foot biomechanics when loading the foot e.g. running. If there are any imbalances in the strength or flexibility of these muscles, this can lead to muscle fatigue, altered mechanics and excessive stress being placed on the tibia.
What are the symptoms of shin splints?
Normally, pain is typically felt on the bottom third of the leg and is usually remains localised to the shin. Pain is often dull but may also be sharp in nature depending on the severity of inflammation and other contributing factors. People typically experience pain at the beginning of exercise which often gets better as people “warm up”. Often this pain returns when people finish exercise and are cooling down. Pain may linger for some time after exercise and people may also limp as a result of this pain.
If shin splints are left untreated, symptoms can often worsen, and people may develop stress fractures of the tibia. This is due to the repetitive, stressful “pulling” of the muscle on the bone which causes the bone to crack. Stress factures are a serious condition and appropriate treatment, activity modification and immobilisation needs to be considered.
Why do shin splints occur?
There are several reasons shin splints may occur which include:
- Changes to training programs e.g. changing intensity and frequency of training
- Bio-mechanical foot postures e.g. flat feet, high arches
- Changes in running surface e.g. soft, hard, uneven
- Inappropriate or new footwear
- Poor bone density e.g. Osteoporosis
- Tight/ weak calf muscles
- History of stress fractures.
Who is more at risk of developing shin splints?
- Runners especially long distance
- Jumping sports e.g. netball, basketball
- Overweight/ obese people
- Female athletes due to bio-mechanical/ hormonal differences
How are shin splints diagnosed?
A physiotherapist can diagnose shin splints through a thorough subjective and objective examination. Early management of shin splints is imperative to optimise recovery and prevent further injury. Your physiotherapist may refer you for some imaging e.g. Xray or MRI if they feel it is a necessary.
What Can You Do To Help The Symptoms?
Seeing a physiotherapist to accurately diagnose shin splints and determine the cause behind what is causing the pain is necessary. Treatment initially may include activity modification and settling down inflammation around the area. Correcting any biomechanical abnormalities through an appropriate strengthening and stretching program should be done to help promote healing and optimise biomechanics.
Returning to exercise needs to be guided, gradual and highly individualised as shin splints are complex and recurrence of injury is high if symptoms aren’t managed properly, and the root cause of pain isn’t addressed.
A safe return to activity is a physiotherapist’s utmost priority.
Exercises which can help shin splints:
- Calf stretching
- Eccentric calf strengthening (reverse heel raises)
- Gluteal strengthening
- Deep ankle/ foot intrinsic strengthening
- 1st MTP stretching
If you are suffering from shin splints, don’t hesitate to make an appointment with one of our expert physiotherapists today!