Shin Splints

Daniel Reeves (Physiotherapist – Burnie)

Shin splints are a common injury we see at the clinic. Also known as medial tibial stress syndrome (MTSS), it is an injury characterized by pain along the posteromedial (inside) border of the tibia (shin bone).

It affects the distal third of the shin and pain is diffuse (>5cm) rather than focal/specific.

The cause of shin splints or MTSS is most commonly due to an increase in load that the body is unaccustomed to. This causes overload to the tibia and is usually associated with running activities.

For example, it’s very common for a sports person who has been taking it a bit easy in the off season to return to preseason training and develop sore shins.

Pain is usually worse with running or jumping and can even be worse with walking.

Diagnosis involves you telling us about the history of your pain (activity history, location of pain, aggravating tasks etc.) and a physical examination to determine your current load tolerance.

What Causes Shin Splints?

Muscles that attach on the shin pull on the bone repeatedly during running/walking and cause the area to become painful and inflamed. It is thought that this pain is related to diffuse bone stress and periostitis (inflammation of the periosteum, the connective tissue that surrounds bone).

While training error and a rapid change in loading is the most common cause of shin splints, there are multiple factors that can contribute or increase your risk of shin splints, some of which are listed below:

• Being overweight
• Poor glute strength and hip control
• Weak calf and tibialis muscles
• Tight calf muscles
• Hard training surfaces
• Changes in footwear (e.g. switching from joggers to football boots)
• Increased foot pronation
• Running technique

What will happen if I continue to train through pain?

If you continue training with shin splints you risk causing further injury. This can result in worsening of the bone stress in the tibia and eventually lead to stress fractures. It is definitely better to get on top of this injury sooner rather than be forced to take time off later because of a more severe injury.

Treatment

Load management is the main treatment for shin splints. Load management involves altering how much activity you are performing to reduce aggravation and pain. It also involves graded exposure to loading i.e. slowly easing into activity to avoid large spikes in load on the body.

It is not uncommon for people suffering shin splints to take 3-4 weeks off from their chosen sport to help settle things down.

Addressing underlying muscle weakness and potential contributing factors will also form part of the rehab process. For example, strength exercises for the calf, tibialis anterior and other lower limb muscles may be prescribed if required. Ice massage can also be helpful to relieve pain.

How to reduce your risk this pre-season and beyond

As pre-season for many sports has already started (or will be starting soon), here are a few tips to reduce your risk of suffering shin pain:

• Ease into training after an extended break. Gradually increase distance, intensity and frequency of training
• Perform resistance training for your lower limb muscles
• Continue to perform some form of training that loads your lower limbs during down periods through the year and sporting season
• Take a training day off to recover if required
• If you’re overweight, change up your nutrition habits to lose a few kg’s

If you suffer from shin pain that you believe is shin splints, or would like to lower your risk of developing shin splints coming into a new season, see one of our Physiotherapists who can work through an exercise and management plan with you. For more information call our Burnie office on 64314586.