Shin pain or “shin splints” are used to describe lower leg pain that occurs either on the front outside part of the leg (anterior shin splints) or the inside of the leg (medial/posterior shin splints). Shin splints is the name given to the generalised pain in your shin, however it could be caused a multitude of factors:
– Stress fracture
– Muscle weakness
– Tendon degeneration
The proper medical name for shin splints is Medial Tibial Stress Syndrome (MTSS) and it is the bane of many athletes and runners. It can often be described as “too much, too soon”, occurring in athletes and weekend warriors who build up their training too quickly or who change the type of workout regime abruptly; for example switching from running on flat surfaces to sand or hills.
At Physio Fit, we love treating patients with shin splints to help you to achieve your goals and return to the exercise that you love! As physiotherapists, we have extensive knowledge of the musculoskeletal system and use our expertise in hands on treatment and exercise prescription to ensure we rid you of your Medial Tibial Stress Syndrome for the good.
Your feet and ankles are a vital part of everyday movement and activity, and it is incredibly important to look after them. We often don’t pay much attention to them when everything is pain free, however your feet, heels and ankles are all vulnerable to pain and injury; and trust us, you don’t realise how much you rely on your ability to move pain free until you can’t anymore!
Physiotherapy is not just a reactive treatment to shin splints, it can also be a great method at preventing the issue in the first place, and a prevention is always better than a cure. Through careful and gradual loading as you increase your exercise, we can avoid the dreaded shin splint pain altogether. Read on to find out how you can apply this to your own training and sitting on the sidelines frustrated and in pain.
What else can cause Shin Pain?
Shin pain doesn’t always mean you have shin splints, there are many different possible reasons for shin pain & that is why a diagnosis from a health professional is an important first step in your recovery.
Shin pain could potentially be a sign of another problem, Compartment Syndrome. a swelling of muscles within a closed compartment which creates pressure. Symptoms include pain, unusual nerve sensation and muscle weakness in your lower leg, which is typically not specific to the medial tibial area (the inside of your lower leg).
Shin pain could also be a sign of a stress fracture – an incomplete crack in the bone. This is more serious than shin splints and can often be found with a definite spot of pain in the medial tibial area, rather than the generalised pain of true shin splints. A stress fracture will require some modified activity to allow the bone time to heal, before a rehab program that will identify any bio-mechanical issues whilst gradually increase the load going through your shin bone.
Physiotherapy for shin splints?
We have a defined process for the treatment of your shin splints:
- We help to relieve your pain as fast as possible & to create a plan to get you back to what you love doing
- We work with you to improve your mobility around your foot, ankle and lower leg
- We’ll help you to improve the strength of your lower leg musculature to return to activity
- Together we will define a return to activity plan that will ensure you avoid a flare up of your shin splints
- Finally, we will create an injury prevention program to avoid shin splints rearing their ugly head in future!
To reduce your pain we can use a variety of different techniques including:
- Dry Needling
- Activity modification
It’s important to remember that shin splints are an injury due to improper load management during exercise. This means that we will work with you to create strict protocols for return to activity to ensure your success. If you experience a flare up during the reloading process, that’s perfectly okay & we will adjust your protocol accordingly – it just means that your lower legs have been stressed slightly too much and we simply need to pull back slightly.
How long do shin splints last?
One of the most frustrating things I hear every year at the start of footy season is ‘oh yeah I’ve got shin splints but I just deal with it because there’s nothing I can do to fix them’. We get frustrated hearing poor advice like this because there is so much we can do to reduce the duration of your pain and have you back doing what you love.
Without treatment and with continual aggravation, especially with running on hard surfaces, it’s not unheard of for shin splints to last 1 – 2 years! With effective treatment aimed at de-loading the soft tissue around your shin, bio-mechanical analysis & gradual reloading, we can have you pain free and back doing what you love in between 6 – 12 weeks.
What does load mean in the context of injury?
When we are discussing load in relation to shin splints, we are referring to the amount of force going through the different structures in your lower leg over a defined period of time, typically a week. Load can be affected by many different factors such as:
- The surface you run on
- The length of your run
- How fast you run
- Your running technique
- Your footwear
- Rest between sessions
- The total volume of running per week
Why do Shin Splints occur?
Too much load – it really can be as simple as that! We feel like a broken record when people ask us why they keep getting certain injuries but that’s because load is such an important factor when talking about frequently occurring injuries. If you start things slowly and gradually build them up over a period of time then realistically you have a much lower risk of injuries occurring. Shin splints like many other injuries, commonly occur when we get impatient and don’t want to wait for our body to adapt to be able to tolerate an increase in activity.
On top of this there are so many other factors that can contribute to that pesky shin pain starting again. From calf and hip strength, to footwear or the surface you run on, it can all have an effect. The good news is there’s plenty of ways to change up your training to help get rid of the pain!
How do I stop this from happening every year?
There is a multitude of things we can do as physiotherapists to help your shin splints, but there’s also many things you can do yourself too!
First of all, making sure your calves are strong by doing plenty of strength exercises. Seriously, people often forget that their calves are a muscle that can and should be challenged like every other muscle (and we get it they don’t grow and get massive as easily as other muscles but they can still get strong!)
While strength is the number one factor to work on, we must also ensure we are doing adequate stretching, mobility and release work (foam rolling or spikey ball) to keep those muscles nice and loose and ready for your next session!
The next most important thing is to not go from zero to 100 in terms of your running or sports training. You’re going to have to take some time to build up your training and that is okay. What’s the point of rushing things if it just means you’re going to end up with shin pain and not being able to run anyway right?
Most people have heard of the old 10% rule, but the good news is that this has been updated through research allowing a slightly faster increase in mileage! So whilst zero to 100 is too fast, most people can safely increase their weekly running load by 20% (if running between 10-20km per week) to 30% (when covering less than 10km each week)!