Shin Splints!

Updated: Aug 19

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What are Shin Splints?

Also referred to as Medial Tibial Stress Syndrome, Shin Splints are pain felt along the middle third of the posteromedial border of the Tibia (the inside border of the shin). Shin Splints are common in runners. The pain often decreases when doing an effective warm-up, however, the pain then returns the following morning. Sound familiar?


Between 4-19% of athletes develop Shin Splints at some point. A key indication that you have Shin Splints is that the pain spreads further than 5cm in length, however, if the pain is more localised, there is a risk you have a stress fracture to the shin. It is supported that Shin Splints occur due to Periosteal Inflammation and that concurrent leg injuries are common in around 1/3 of athletes.


Risk factors for Shin Splints

• Increased BMI (Body Mass Index) (May increase Tibial load and cause bowing, which produces hyper-stimulated periosteal activation, which would be ideal, but excessive BMI may be causing excessive overloading)

• Increased Navicular-drop (This relates to decreased Arch Height, which may reduce Internal Rotation of the Tibia which would then lessen the ability to absorb forces which places the Tibia under increased load)

• Increased Plantarflexion (Speculation as to why this is a risk factor but no concrete conclusion)

• Increased External Hip Rotation (Same as above but relates to transferred forces)


How do you heal Shin Splints?

There is conflicting evidence for the treatment of Shin Splints varying from; Activity Modification, Orthotics, Manual Therapy, Sports Massage, Strengthening and Stretching.


Some evidence suggests that there is no validated evidence to support the benefits of any treatments suggested. Nonetheless, we will go with some that may benefit those suffering from Shin Splints.


- Changing your activity from high load to low load may help the recovery process whilst maintaining cardiovascular fitness. This can be attained through swapping running for swimming or cycling.


- Working with a professional to help alter your walking or running mechanics can help to decrease the load.


- Some people may benefit from cushioned orthotics with arch support, though, some may not.


- Transverse Frictions to the Flexor Digitorum Longus and Soleus may improve symptoms and encourage recovery.


- Myofascial Release parallel to the Tibial Shaft may provide some pain relief.


- There is evidence to support the use of Cupping Therapy but ensuring you avoid the Tibial Boarder.


- You may benefit from Sports Massage to the calf complex.


- Exercise should focus on improving the Strength and Flexibility of the local musculature. There is also evidence to support the use of PNF (Proprioceptive Neuromuscular Facilitation) Stretching.


- There is little evidence to support the use of Electrical Stimulation, Iontophoresis and Ultrasound.


- There is no use for a Pneumatic Leg Brace in the recovery of Shin Splints.


Hopefully, you have gained a better understanding of Shin Splints by reading this quick post and understand how you can recover safely.


Kindest Regards,


Ethan

Ultimate Recovery



References

Brukner, P. and Khan, K., 2011.Clinical Sports Medicine. McGraw-Hill Education.


Hamstra-Wright, K., Bliven, K. and Bay, C., 2014. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis.British Journal of Sports Medicine, 49(6), pp.362-369.


Moen, M., Bongers, T., Bakker, E., Weir, A., Zimmermann, W., van der Werve, M. and Backx, F., 2010. The Additional Value of a Pneumatic Leg Brace in the Treatment of Recruits with Medial Tibial Stress Syndrome; a Randomized Study.Journal of the Royal Army Medical Corps, 156(4), pp.236-240.


Winters, M., Bakker, E., Moen, M., Barten, C., Teeuwen, R. and Weir, A., 2017. Medial tibial stress syndrome can be diagnosed reliably using history and physical examination.British Journal of Sports Medicine, 52(19), pp.1267-1272.


Winters, M., Eskes, M., Weir, A., Moen, M., Backx, F. and Bakker, E., 2013. Treatment of Medial Tibial Stress Syndrome: A Systematic Review.Sports Medicine, 43(12), pp.1315-1333.


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