The definition of medial tibial stress syndrome (‘Shin Splints”) is as an exercise-induced pain along the inside of the tibia and is a common overuse sports injury that affects up to 19% of the population. The team at our Newmarket physio clinic has vast experience in treating this often debilitating injury.
The exact pathology of shin splints is equivocal, with both bony overload or periosteal inflammation (inflammation of the outside of the bone) being reported. The pain of shin splints, over an area of >3 centimeters of the tibia (shin bone), is felt in the area where two particular muscles insert into the tibia, Tibialis Posterior and Flexor Digitorum Longus. These muscles act to invert (turn inwards) the foot and flex the toes respectively.
Despite the unclear pathology, shin splints can be a debilitating condition that impacts activity levels significantly. The pain can be quite limiting and may even be an early warning sign of a stress reaction/fracture. Our highly trained physiotherapists, based at our Newmarket clinic, can rule this diagnosis out and implement an appropriate management plan.
Shin splints are typified by pain in the lower half of the shin bone and is felt when you start exercising then eases as you have warm up and comes back after you stop. Some people experience a dull ache over their shin that lasts for quite a while after exercise stops, whilst for others, the pain may be sharp and fades quickly.
The pain is often progressive and becomes worse with shorter distances. Eventually shin splints severely impacts activity levels as the pain becomes too severe to continue exercise.
Shin splints are predominantly seen in people who do a sudden increase in running loads and is especially common after a long period of inactivity i.e. not training over the off season for rugby or football and then starting pre-season training. Activities that require repetitive weight bearing of any kind, such as marching or high impact sports can cause shin splints. Although the pathology of shin splints is unclear, studies have been able to identify certain risk factors that may predispose someone to shin splints. These include;
The first step is to ascertain that in fact you have shin splints and not a stress reaction/fracture of the tibia. Current research has shown that shin splints can be reliably diagnosed using history and a physical examination and is currently the gold standard of diagnosis. Imaging for shin splints is not as reliable as a physical examination but can be used if a stress fracture is suspected. During your assessment, our physiotherapists will assess the lower limb biomechanics and any contributing factors such as training load, footwear and surface you are training on. A period of relative rest may be recommended along with a targeted strengthening and stretching program for any tight or weak muscles. Strengthening would look at the entire kinetic chain (whole leg) from your core down to your feet. The use of strapping or Kinesio taping may be used and advice on adapting your training program to a level that is optimum for you.
Switching to low-impact activities such as swimming, cycling and yoga may also help to maintain fitness during recovery. Your running technique will be analysed, and any training errors may be corrected. When getting back into your training routine, it is usually recommended that distances are not increased by more than 10% per week. This allows the tissues of the body to react to the increased demands and adapt accordingly.
If you are finding the pain of your shin splints starting to get unbearable, book an appointment with highly trained physiotherapists at Cairnhill Physiotherapy in Newmarket and start to get on top of your pain and back to your sport painfree.