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Shin Pain and Treatment

Shin Splints - An MSK Therapy perspective

Shin pain treatment brisbane

Shin Splints is another reasonably common running injury, though the condition does not only affect runners. Many sports and activities involve placing loads on the lower legs, which can lead to Shin Splints. As per the name, Shin Splint pain occurs in the lower leg and shin bone or Tibia area. The diagram below shows a lower left leg, the larger Tibia (shin bone), a smaller Fibula and part of the ankle/foot complex.

The pain may appear over a small or large shin area. The pain can dull in nature, though more often than not, it is quite sharp. Sometimes, people can push through the pain in the earlier stages of the condition.  However, the pain tends to intensify longer term and usually stops activity. Sufferers of the injury tend to notice pain shortly after commencing exercise. Shin splints can often affect both shins too. The pain usually fades with rest in the shorter term, though more chronic cases may remain even with rest.

Image of the Tibia and Fibula in relation to Shin Splints

Image of the Tibia and Fibula

Images produced with kind permission of 3d4medical.com from Essential Anatomy 5

(Copyright © 2018 - 2024 3D4Medical. All rights reserved.)

Possible Causes of Shin pain

The “Basic Running Injury Preventive Measures” article covers many of the typical variables that can lead to Shin Splints, such as:-

  • A rapid increase in mileage, distance or speed.
  • Altered running surface.
  • Footwear changes, old, new.
  • Additional weight carriage, physically (overweight) or additionally (rucksack etc.)
  • Biomechanical variations which affect the "Kinetic Chain" and gait (flat feet, previous injuries).
  • Hypertonic (tight/shortened muscles, such as Tibialis Anterior or Calf Muscles).

Any combination of the factors above can place an extra load on the Shin Bones (Tibias) and the surrounding soft tissues. Such excess load can then create microtrauma in the soft tissue structures near the bone. Trauma leads to inflammation and swelling within the affected tissues, adding pressure to the bones and other tissue structures. The pressure within the lower leg then leads to shin pain and restricted movement, and a cycle can quickly form without proper action. Also, the body naturally adapts to avoid pain, which can cause other issues later (see the Soft Tissue Adaptation to activity and injury article). It is relatively easy to irritate things further if one does not take proper action. Hence, shin splints can easily result in persistent pain when the condition becomes chronic. Chronic conditions can prove more complex to treat due to a range of factors (see the article on Chronic or Persistent Pain).

Professional help and treatment options

One of the critical aspects of treatment with Shin Splints is early intervention, as this aids the body's healing process (see article on Soft tissue repair, healing and scar tissue). Rest, Ice, Compression and Elevation (R.I.C.E.) can be beneficial in the condition's early stages. Ideally, one does not want to irritate the injured tissues further, so rest is essential. The speed at which one can return to activity can vary depending on one's early intervention strategy. If one keeps on just trying to run through the pain, then it is easily possible that one will end up having to stop activity for weeks and even months. Rest does not mean that one cannot train; in some cases, other low-impact training options are available. However, seeking professional advice before starting suitable training activities such as water running is best. A qualified professional should know the most likely cause of the initial injury and treat any specific affected tissues. A trained professional will also be able to check other aspects of biomechanics and the "Kinetic Chain" (see Biotensegrity and how everything is connected article for a better explanation). A professional can then treat and advise accordingly. The author has been treating sports-related musculoskeletal injuries since 2006 and has found that "Shin Splints" can be resolved relatively quickly with conservative treatment. In particular, the author has found Myofascial Dry Needling and soft tissue therapy (Sports and Remedial Massage techniques) to be highly effective. In some cases where biomechanical changes have occurred, the author has found structural and soft tissue therapy very effective. Shin splints are another lower extremity condition that can quickly become chronic and extremely painful. The article on Finding a good, ethical Musculoskeletal health professional - An M.S.K. Therapy perspective offers some advice on what to expect from a good patient-centred practitioner.

The article was written by Terry Davis MChiro, GradCertMentHlth, BSc. (Hons), Adv. Dip. Rem. Massag., Cert. WHS.

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About the Author

As of December 31st 2020, the author chose to leave the Chiropractic profession due to a planned move back to Australia, where his training and education are not recognised. Terry no longer works as a Chiropractor and works as a Myotherapist in Morningside, Brisbane. He developed an early interest in soft tissue therapy and Myofascial Release Techniques methods in 2006 for treating various conditions. Terry's interests in human performance and trauma have naturally led to him developing a specialism in treating work and sports-related musculoskeletal injuries and Chronic Pain symptoms.

The author possesses an unusual background for somebody who trained in the McTimoney Chiropractic technique. His education, training, and practical experience span over two decades and relate to health's physical and mental aspects. He also needed to push his body and mind to the limits of physical and psychological endurance as part of his time serving in Britain's elite military forces. His education includes a bachelor of science degree in Business Management, with a specialisation in psychology and mental health in the workplace, an Integrated Masters in Chiropractic, MChiro and a multitude of soft-tissue therapy qualifications (see the about section for more details). His soft tissue qualifications range from certificate level right through to a BTEC Level 5 Advanced Diploma in Clinical Sports and Remedial Massage Therapy. He has also taught as a senior course coach at the Advanced Diploma level (Myotherapy / Musculoskeletal Therapy) in Australia, both theoretical and practical aspects, including advanced Myofascial Release Techniques and has certification in training and assessment. Terry will have taught many of the first students to train as Myotherapists in Brisbane. Terry's combination of knowledge through education, training, elite military service, and personal injury history has paid dividends for the patients he sees and has treated over the last 16 years. Terry is still extremely active and enjoys distance running, kayaking, mountain biking and endurance-type activities.