What are shin splints?

Shin splints are a generic term for pain on the medial (inside) aspect of the tibia (shin bone) which can have several different causes. The most common cause of shin pain is called medial tibial stress syndrome (MTSS) amongst health professionals and sports injury therapists.

What is happening to your shin to cause the pain?

The pain of shin splints is caused by irritation and inflammation to the lining of the shin bone called the periostium. The tibialis posterior and soleus muscles of the lower leg have their attachments on the medial boarder of the shin. When the muscles overwork they begin to irritate and inflame the periostium which causes focal tenderness along the site of their attachment to the bone.

What causes shin splints?

There are numerous potential causes of shin splints.

Training errors

Typically shin splints present with changes to training. It most commonly occurs when you increase the frequency and /or intensity of your training. The most common story I hear from clients is one where they usually go for a 3 mile run once per week then suddenly start running 6 miles 5 times per week. This sudden increase in demand in a short space of time is too much for the muscles to tolerate and they become overused. To avoid this, training volume and intensity should be increased gradually over a longer period of time. Running on hard surfaces such as concrete will also increase your likelihood of developing shinsplints, therefore running on more forgiving surfaces such as grass or dirt tracks is recommended.

Biomechanical insufficiencies and poor footwear

You are at more risk of developing shin splints if you have over pronated (flat) or less commonly supinated (high arched) feet. If you have either of these foot types you need to ensure you have the appropriate footwear and/or orthotics to support you feet. In addition your footwear should have good shock absorption in the heel.

Muscle imbalances

Poor core stability and hip and knee control also increase your likelihood of developing shin splints. It is therefore important to ensure you follow a comprehensive abdominal, gluteal and quadriceps conditioning program. In addition, tight hamstrings and calf muscles also adversely affect lower limb biomechanics so regular stretching should be incorporated into your exercise program.

Warm up and cool down practices

It is important to ensure your body is sufficiently warmed up before you start exercise. This will ensure the blood vessels which supply the muscles are sufficiently dilated (opened) before beginning exercise. Once you are finished exercising it is important to cool down sufficiently to ensure you thoroughly flush the lactic acid (waste product) from your muscles. At the end of your cool down you should stretch your calf muscles to ensure they don't become too tight. The tighter the muscles, the stronger the pull on the periostium and the increased likelihood of shin splints.

How do you treat shin splints?

An assessment from a chartered physiotherapist is imperative to accurately diagnose the cause of shin pain. However a typical assessment and treatment plan should include the following:

Biomechanical assessment to identify biomechanical issues and provide appropriate intervention
Advice regarding the use of ice and non steroidal anti-inflammatory medication to address the pain and swelling
Advice regarding modification of training to create the optimum environment for healing
Advice regarding appropriate footwear and the provision of suitable orthotics
Supportive sports taping to off load the over worked muscles
Strengthening and stretching programs for the appropriate muscle groups
Specific soft tissue mobilization (various deep tissue massage techniques)
A graded rehabilitation program to safely guide you back to your previous level of activity

The author Darren Wigg is a leading sports injury specialist and highly qualified physiotherapist treating the British Swim Team as well as many other professional athletes. Check out his professional profile and more advice at Fitbritz - Darren Wigg

Fitbritz is the UKs largest Sports, Health and Fitness Portal find everything to do with sports health and fitness. Search for sports health and fitness facilities, exercises classes, fitness trainers, health professionals, therapists, jobs and courses. Buy tickets to top sports events and find offers on activities. Get health and fitness advice, articles and watch videos, from leading fitness professionals at www.Fitbritz.com

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