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Shin Splints

What Is It?
Shin Splints is pain caused by an injury to the anterior or posterior tibialis muscle where it attaches to the shinbone (tibia). Pain is generally felt along the front or inside edge of the tibia and is common in athletes who run and jump.  Repetitive motions such as running and jumping can cause the anterior or posterior tibialis muscles to pull away from the tibia, resulting in inflammation and discomfort.  Problems that mimic shin splints are compartment syndrome (CS) and stress fractures, which tend to significantly worsen as you run forcing you to stop.  Shin splints are not typically so severe in intensity.

What Causes It?
Shin splints usually result from overuse.  Repeated and excessive dorsiflexion movements of the foot (foot pulled up to the shin) can cause damage and tearing where the anterior tibialis muscle attaches to the tibia.  Excessive pronation will also strain the tibialis muscles as they try to stop your arch from collapsing.  Shin splints commonly occur after sudden changes in training.  Increasing running speed, distance and running on hard or angled surfaces can also contribute.  Shin splints can also occur from running in racing flats or in worn shoes.  Following is a list of predisposing factors:

  • Taking up new activities such as jogging, sprinting or sports with quick stops and starts
  • Imbalances in foot alignment such as excessive pronation
  • Running downhill, especially fast while trying to decelerate by heel striking
  • Muscle imbalances in the leg and foot
  • Tight calf muscles or lower leg muscles with too many trigger points
  • Excessive heel striking with each step
  • Running too many days in a row without proper recovery
  • Poor running form such as over-striding or improper leg alignment
  • Sciatic or tibial nerve tension, which may stem from your low back

How Can I Fix It?
Most cases of shin splints respond to rest and activity modification.  Restoring proper mechanics, muscle balance, and strength to the leg and foot are the keys to long-term recovery.  Determining and eliminating the causes are important first steps.

  • Decrease running mileage, hills, and intensity to below your pain threshold
  • Decrease heel striking by shortening your stride and relaxing your feet
  • Substitute cycling, swimming, elliptical, etc. if you can do them pain free
  • Use ice packs or a frozen ice cup to massage the shin (if acute), and heat (if chronic)
  • Stretch your calves to decrease stress on the shin muscles
  • Strengthen your lower leg/foot muscles to decrease pronation
  • Replace your shoes if they are worn out (more than 500 miles or 6 months old)
  • Trigger point dry needling to your shin and calf muscles to release tension
  • The Physical Therapists (PT) at ALTA can evaluate your injury, nerve tension and running mechanics.
  • Deep tissue massage to the lower leg muscles using a foam roll or rolling pin
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