Clinically known as Medial Tibial Stress Syndrome or Medial Tibial Periostitis, ‘Shin Splints’ is a colloquial term used to describe pain along the front and inside of the shin.
Pain is often made worse by exercise and is accompanied by tenderness along the inside of the tibia.
Shin Splints is one of the common overuse injuries that we see, particularly in the running population.
What is it? Inflammation or irritation of the tibial periosteum (lining of the bone). The Tibialis posterior is the main culprit although there are several layers of fascia and connective tissue around here that can also contribute. The Tibialis Posterior originates along the inside of the shin tracking down into the foot and attaching into the medial arch. It plays a major role in support & control of this medial arch.
Repetitive activities such as running can overload this muscle, particularly when done in poor footwear or with unfavourable running biomechanics.
There are a few stages of shin splints
- Mild: Pain is usually only felt after an intense workout and is diffusely tender along the shin.
- Moderate: Pain can be felt in normal daily activities such as walking. There may be morning pain and stiffness.
- Severe: Pain can be felt at rest. High risk of progressing to a Stress Fracture of the tibia.
Are there risk factors? Yes.
Unfortunately some people are prone to developing injuries such as shin splints thanks to underlying biomechanics. Some of the common risk factors are;
- Pronated feet (where the arch naturally collapses a little)
- Excessively tight calves
- Reduced ankle and / or hip mobility
- Poor pelvic stability – reduced core control and / or gluteal strength
- Lower limb alignment – bow leg or knock knee
There are also several factors that you are more in control of;
- The first is SHOES. Running in unsupportive shoes can be an express ticket to the physio. The sneaker game has changed, there is an overwhelming amount of choice when it comes to selecting appropriate running shoes. My advice would be to go with something you know, if you have always run in Asics and they have served you well, stay with Asics. Many running stores now offer a basic assessment that you could use as a guide, just be wary of them pushing the most expensive shoe your way. Save the super light fly knit weave sneakers for lower impact exercise and latte dates in your active wear!!
- TRAINING LOADS: Try to be mindful of sudden increases in distance and intensity of your running sessions. If you are just getting your running legs back don’t kick start it with a 10km road run. Ease your way back to give your body a chance to adjust and ensure adequate recovery between sessions.
- TRAINING SURFACE: Grass, trail & sand are much more forgiving on the legs than concrete so stick to these where possible
What can physio do?
- Address Biomechanics– strengthen weak muscles, loosen tight overactive muscles, mobilise stiff joints
- Reduce inflammation – taping techniques, massage, dry needling.
- Education – regarding footwear, training loads.
A little take home advice. Running through shin pain doesn’t make you hardcore. Shin splints can develop into a stress fracture if not addressed and managed properly.
Suffering from shin pain? Rest & Ice are a good starting point until you seek professional advise from your physiotherapist. They will be able to guide you with the rehabilitation and long term management that you need to get you back running as soon as possible.