Shin Splints: Everything You Need to Know

diagram showing where shin splints can cause pain

Shin splints are a common injury that we see at the clinic, mainly affecting those who participate in high impact activities such as running, netball, football, basketball, soccer etc.

What Are Shin Splints?

Also known as medial tibial stress syndrome, shin splints are an overuse injury that result in pain through the lower leg.

It occurs due to repetitive stress placed on the shin region, often in high impact sports where there is considerable force and pressure placed on the lower leg. Essentially, the pain is present due to the body’s inability to heal the trauma along the shin due to repetitive stress.

The muscles involved in shin splints include tibialis posterior and tibialis anterior. Both of these muscles run along the tibia (shin bone) and attach within the feet. In some cases, if not treated appropriately, shin splints can also progress into a stress reaction or stress fracture along the tibia (shin bone).

 

What Do Shin Splints Feel Like?

Those who have experienced shin splints will usually describe a dull aching sensation that runs down the shin. It can also be coupled with cramping through the lower leg. Patients may also report a feeling of tiredness or fatigue from the knee down to the ankle that does not necessarily ease with rest.

 

What Causes Shin Splints?

Shin Splints can be caused by a range of factors including:

  • Poor Training Surfaces & Conditions:

A poor training surface can place excessive strain and pressure not just on your lower legs, but your entire body. If it does not mimic your playing conditions or is too hard (such as concrete), it can lead to injuries including shin splints.

  • Improper or inappropriate footwear:

Footwear is extremely important during exercise. It is important that your footwear is appropriate to both your foot type and the type of activity you are participating in. Shoes that do not adequately support your feet and ankles can place excessive pressure through your lower legs.

  • Pes Planus Foot Type (Flat Feet):

Research tells us that having a pes planus foot type may increase your risk of developing shin splints, when in combination with other factors as well. In a pes planus foot type, there is usually a degree of tibialis posterior dysfunction. The tibialis posterior muscle helps to support the arch and if it is not functioning properly, it is prone to injury. A pes planus foot type also puts pressure on the ankle joint and forces the muscles crossing into the feet to work harder to try to support the ankle and feet properly.

  • Overtraining or Overuse:

It is important when training for a competition or game that you don’t ‘overdo’ it. If you’ve played any kind of sport you’ve probably heard someone say that to either yourself or a team mate. By not allowing your body to rest and recover, you are prone to injury. Shin splints are classed as an overuse injury because they develop over time when there is excessive repetitive stress. If your body is not given the time it needs to heal, injury is a given.

  • Rapid Increase in Training Load (Intensity, Duration and/or Frequency):

Generally speaking, we recommend sticking to what’s called the 10% rule. This means that you should not be increasing your activity parameters (intensity, frequency or duration) by more than 10% each week. By sticking to this rule you help to reduce your injury risk.

  • Knee Position Abnormalities:

Knee position can also affect the ankle and foot position. Genu valgum (knocked knees) or genu varum (bowed legs) can cause the muscles of the lower leg to overwork.

  • Muscle Tightness or Weaknesses:

Tightness or weaknesses within the muscle can result in compensations made by other structures.

  • Limb Length Discrepancy:

Most people have one leg slightly longer than the other. This is generally not a problem if this difference is less than 1cm, however anything more than this can place more pressure from the back down to the feet.

 

Who Can Get Shin Splints?

Shin splints can affect anyone in the population, however it is most common in those who participate in high impact sports, those with pes planus (flat) feet and those who increase their physical activity levels too quickly.

 

How Does a Podiatrist Diagnose Shin Splints?

To diagnose shin splints, there are a variety of different assessments that a podiatrist will perform.

  1. Firstly, we take a thorough history of the injury and pain. This will involve asking about your activity type, intensity, frequency and duration. We will also ask about when the pain started, what it feels like, when it is at its worst and so on.
  2. We will assess the range of motion through your feet, paying particular attention to the ankle joints where the affected muscles cross over into the foot.
  3. Muscle testing will be performed on the different muscles and compartments of the lower leg.
  4. We will test your calf flexibility and strength to identify any weaknesses that need to be addressed.
  5. A weight bearing (standing) and gait (walking and/or running) assessment will be conducted to identify any structural or functional abnormalities or weaknesses that may be causing your pain.
  6. Your footwear will be assessed thoroughly to check for abnormal wear patterns and to assess whether they are appropriate for you.

 

What Treatments Are Available for Shin Splints?

R.I.C.E

  • The initial treatment option until you can have a thorough assessment is to follow the RICE principle of rest, ice, compression and elevation. Icing using a polystyrene cup allows you to massage the area as well as apply ice to reduce inflammation.

Taping

  • Taping can help to offload and support the injured structures to essentially give them a break for a few days.

Orthotics

  • Orthotics can assist with providing long term support in your footwear to avoid future injury and to properly support your feet all the way up to your back. Learn more about Orthotics here

Footwear Modifications

  • We know that footwear is very important and that wearing the wrong shoes can cause a whole range of problems. Sometimes, we are able to make small modifications to your runners such as using a small heel lift to take pressure off the legs. We will also be able to recommend different brands and styles of shoes that would suit both your feet and activity type.

Trigger Point Dry Needling

Shockwave Therapy

Stretching and Strengthening Programs

  • Stretching and strengthening programs are extremely important when trying to rehabilitate an injury. We look at the body as a whole and try to stretch and strengthen both the injured structures as well as the surrounding structures. This will improve your overall strength and reduce the risk of compensation injuries.

 

Have more questions about shin splints or want to book in to see one of our superstar podiatrists?  You can book online here or give us a call on 03 9432 2689 to book your appointment today!

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