Shin Splints - An MSK Therapy perspective
Shin Splints are another reasonably common running injury, though the condition does not only affect runners. There are many sports and activities which involve placing a load on the lower legs and which can lead to Shin Splints. As per the name, Shin Splint pain occurs over the shin bone or Tibia area of the lower leg. The diagram below shows a lower left leg, the larger Tibia (shin bone), smaller Fibula and part of the ankle/foot complex.
Image of the Tibia and Fibula
Images produced with kind permission of 3d4medical.com from Essential Anatomy 5
(Copyright © 2018 - 2021 3D4Medical. All rights reserved.)
The pain may appear over a small or large area of the shin. The pain can dull in nature, though more often than not is quite sharp. In some cases, people can push through the pain in the earlier stages of the condition. However, the pain tends to become rather intense longer term stopping activity. Sufferers of the injury usually 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 in more chronic cases may remain even with rest. As with many types of injury, the body will naturally adapt (see adaption article) to avoid pain, which can cause further problems.
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 number of the factors above can place additional load on the Shin Bones (Tibias) and create microtrauma and resulting pain. If Shin Splints are left untreated, they can become quite challenging to resolve.
Professional help and treatment options
One of the critical aspects of treatment with Shin Splints is early intervention, as this aid with the bodies healing process (see article on healing). Rest, Ice, Compression and Elevation (R.I.C.E.) can be very useful in the early stages of the condition. Ideally, one then does not want to further or repeatedly irritate the injured tissues, and so rest is essential. The speed at which one can get back to regular running activity will largely depend 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 and in some cases there other low impact training options available. However, it is useful and highly advisable to seek professional advice before embarking on suitable types of training activity such as water running. A suitably qualified professional should be able to identify the most likely cause of the initial injury and treat any specific tissues which have been affected. A trained professional will also be able to check other aspects of biomechanics and the “Kinetic Chain” (see Biotensegrity 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 other cases and where there have been biomechanical changes the author has found structural and soft tissue therapy to be very successful. Shin splints are another lower extremity condition that can easily become chronic and extremely painful. The article on Finding a good, ethical Musculoskeletal health professional - An MSK Therapy perspective offers some advice on what to expect from a good consumer/patient-centred practitioner.
The article was written by Terry Davis MChiro, 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 and pursue studies within the Physiotherapy field. He no longer works as a Chiropractor and works as a Myotherapist in Morningside, Brisbane. The author possesses an unusual background for somebody who trained as a Chiropractor (McTimoney). His education, training, and practical experience span over two decades and relate to both health's physical and mental aspects. He has also needed to push his own 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. Terry also has extensive experience in security, work, health and safety and holds relevant certifications. He has also taught as a senior course coach at 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 consumers he sees and has treated over the last 15 years. He has extensive experience treating chronic pain and work and sports-related musculoskeletal injuries. Terry is still very active and enjoys distance running, kayaking, mountain biking and endurance-type activities.