Shin splints is the general name given to pain that arises on the front of the lower leg. There are a number of different causes of pain in the shins, but when the term ‘shin splints’ is used it often refers to periostitis. The periosteum is a sheath that surrounds the bone. If it gets inflamed, as with periostitis, it can cause pain. The inflammation is as a result of an excessive pull from the muscles that attach onto the bone. The two main muscles that are associated with shin splints are tibialis anterior on the front of the shin and tibialis posterior just behind the shin. It is an extremely common injury in runners but can occur in any sports that involve running or jumping.
What does it feel like?
The classic features of shin splints are pain or tenderness over the lower shin bone on the inside. The pain is worse with running and may be aggravated by walking. The pain can sometimes ‘warm up’ so it may feel better towards the end of a run. But if the periosteum is quite inflamed it may give a continual ache. The pain is not often so severe it forces withdrawal from sport.
Why does it happen?
There are a number of possible causes which include biomechanical abnormalities that place excessive strain on the area due to training faults.
Common biomechanical dysfunctions at the foot:
- Inflexible calf muscles
- Stiff ankle joint which prevents sufficient dorsiflexion (upward movement of the ankle)
- Overpronation-excessive or prolonged rolling in of the foot.
- Poor flexibility of the big toe. The big toe is crucial to normal foot function in walking and running and inflexibility can affect the ability to ‘push off’ during these activities.
There are also a number of biomechanical dysfunctions higher up the leg and into the pelvis and back that can contribute to shin splints. The strength and flexibility of the top of the leg impact on how the foot is controlled as it hits the floor.
Common training errors:
- Using incorrect or worn out trainers
- Overtraining or a sudden increase in training
- Excessive training on hard surfaces
- Erratic training- as this does not allow the body to get used to training
What can you do about it?
- Rest- especially in severe cases. In milder cases you may be able to cut back on training and run on a softer surface until the symptoms subside.
- Ice- wrap ice in a damp towel and place it on the shin for 20 minutes
- Perform calf stretches to gastrocnemius and soleus muscles muscle groups
- Maintain your fitness by non-impact exercise until you have recovered
Seeking medical advice will ensure an accurate diagnosis. This is particularly important if the symptoms are not improving as there are a lot of other causes of shin pain. The treatment will depend on the cause of pain but may include:
- Stretches and deep tissue massage to restore muscle length
- Re-education of running pattern and advice on training
- Specific strengthening to correct muscle imbalances