Shin Splints
Shin Splints
is a general term given to pain that occurs after activity between the
knee and
ankle mostly occurring at the front or inside of the leg around the shin. We
see this presentation frequently at the clinic and we quickly set about discovering
the tissues that are causing the symptoms.
It is important to firstly rule out other “red
flag” causes of the symptoms such as:
- Compartment Syndrome
- Stress fracture
- Nerve
entrapment
- Vascular
injury i.e. DVT
What Causes Shin Splint?
Changes to
your exercise regime will change the load on your tissues i.e. muscles,
ligaments and bones. These tissues will react to that change, this is called an
“adaptive response". If this change in
load is too fast, the tissue does not have time to adapt fully before you are
loading the muscle again with the next exercise session. Continuing the
repeated trauma will result in injury.
How to assess and treat Shin Splint?
When
investigating the presenting symptoms we first look for the damaged tissue.
This means looking at individual bones, muscles, ligaments, fascia and the attachment
areas of all of these structures. Once the damaged tissue has been identified we
will then look at changes in the patient’s routines that coincide with the
onset of symptoms such as changes in training programme cycles, cross training
activities, to changes in shoes. What has the patient done differently that
would cause the injury?
We also
look at the patient’s biomechanics for the particular exercise they are doing
to see if there is any weakness causing excessive pressure on the legs. For
example, how the patient controls pronation of the foot on loading the lower extremity
when running and are the muscles firing in the correct sequence and with
sufficient strength to support running? Running style is a big risk factor for
shin splints particularly heel striking gaits. It is also important to look at
the correct footwear that complements their running style to reduce the stress
on their leg tissues.
Finally we put together a comprehensive treatment plan:
- Remove or
modify the trauma i.e. change the running gait
- Reducing
the inflammation and promoting healing of the damaged tissues
- Dealing
with risk factors i.e. advice on nutrition, poor shoes, running style and exercise
plan.
- Treating
the whole body – not only treating the injury but looking at ankle, knee, hip
and back function and control. Muscle chain strength and firing patterns can
also be looked at
This is a
comprehensive approach that has proved very effective and will be adapted to
each patient and their circumstances. We are constantly improving and adapting
our approach as new research and treatment method develop so you can be
confident you will receive the best treatment and advice available.
1. Loading of healing bone, fibrous tissue, and muscle: Implications for orthopaedic practice