What are shin splints?
Shin splints are very easy to define and diagnose but are extremely misunderstood in terms of management and treatment. In the simplest terms, shin splints are characterized by pain and sometimes swelling of the muscles surrounding the shin. Specifically the Tibialis Anterior muscle (Check out the picture). Trigger points (Tightness) in this muscle can produce local pain and even refer pain down into the foot and toes. This is really common in runners due to the repetitive stress on these tissues that comes with running high miles during the week. I often see this in soccer players as well, especially towards the end of summer when the fields become a little harder and there isn’t quite as much cushion on the field. Now, what the heck can we do about them.
2 Side of Managment… Rest + Suck It Up!
There is a group of people who say that shin splints are normal, that they are a part of running and they will go away eventually. The other group says they are scary and you need to do nothing for 4-6 weeks and hopefully they will feel better. Saying pain and dysfunction is a normal result of a sport is not something that we believe in at Winchester Spine and Sport. The other option to stop doing what you enjoy is ridiculous. Our goal is to help our athletes regain a pain-free sports performance while increasing longevity. That rarely includes sitting or quitting. For shin splints, we are only sitting our patients in extreme circumstances such as compartment syndrome or stress fractures (Very rare).
The real story is that there is something we can do about shin splints, without taking a break from running. Crazy? Keep reading…
Shin splints are always the result of a functional problem. Said another way, the patient’s brain is not choosing to utilize the muscles of the lower leg in the most efficient way. This creates tension in the muscular system, stiffness in the joints, and eventually pain or discomfort. Our goal with treatment is to enforce really good movement patterns with corrective exercise(Dynamic Neuromuscular Stabilization), eliminate the stiffness in the joints(Manipulation), and control the local inflammation with some passive modalities(Laser, Dry Needling, K-Tape, etc.). With these tools, we can make changes very quickly.
After we make changes to the pain and dysfunction I will usually take a look at the running mechanics. A really common flaw we see in running mechanics linked to shin splints is overstriding. In other words, the athlete is landing outside his or her base of support(check out the terrible drawing) which makes it very hard to distribute force throughout the entire leg, putting too much stress through the front of the leg. This technical issue can usually be solved pretty quickly with some mindful running or using a metronome to adjust the cadence of a runner.
Another common misconception in regards to running is that your foot strike (forefoot, midfoot, or rearfoot) predisposes you to injury. However, the research has shown us this is far less important than the posture of the lower extremity during gait. You are just as likely to injure yourself with each of the above foot strikes.