Shin Splints

What are Shin Splints?

The term shin splints is commonly used for pain in the front or sides of the lower leg. It is typically an overuse injury which means one's activity level outpaces their body's ability to recover and repair tissues damaged from use. If shin splints are not dealt with they can lead to a stress fracture in the shin bone.

What are the causes?

When the muscle is overworked stemming from a mechanical disadvantage it becomes damaged and weakened. Weakness of the muscle then causes the muscle to begin to pull away from the bone where it attaches resulting in pain and inflammation. Running sports or hiking are often related to shin splints.

Causes of altered mechanics including leg length discrepancy (one leg is longer than the other), over pronation [collapsed arch], running on cambered surfaces, poor shoe support or weakness in ankle or hip muscles, lack of flexibility in the calf, or poor running technique need to be addressed to correct the mechanics and ultimately find the permanent cure. While rest alone may let the injured tissue heal it does not correct the mechanical cause and pain will occur again.

If the pain is on the inside (medial side) of the shin bone (tibia), the pain stems from the posterior tibialis or the flexor digitorum muscle which control the pronation/supination cycle (flattening and reforming the arch of the foot that occurs with each step). If these muscle work too vigorously placing excessive force along the tibial attachment of those muscles.

If the pain is on the outside (lateral side) of the tibia it may be an issue of the anterior tibialis or the extensor digitorum muscles working too hard. This can occur if the feet are not lifted high enough from the hip so that the ankle muscles have to work harder. This may occur from having an especially long stride. Lateral shin splints may occur from running hills before being sufficiently fit and strong. Some people have a genetic vulnerability for these muscles to become too developed for the space they have and can lead to a more significant problem referred to as Compartment Syndrome.

Treatment from Forster Physical Therapy and Phase IV:

The first step is a comprehensive injury evaluation to determine the likely source of the pain and more importantly where the mechanical deviation has occurred. Initially treatment of the inflammation, pain and swelling if any must be addressed. Inflammation and swelling are two different events in the body's response to injury and must be controlled. Rest, ice, gentle stretching of the calf, properly supporting the long arch of the foot, physical therapy modalities such as ultrasound and electric stimulation, wrapping the lower leg, gentle massage, are initial treatment methods. Once the inflammation is controlled then the true causes can be better addressed. Strengthening and stretching exercises for the entire lower body with specific exercises for the affected area must be instructed to re-strengthen the damaged muscles and address the mechanical cause of the problem.

An important component of the Forster Physical Therapy treatment for shin splints is our proprietary deep tissues massage to the compartment where the problem muscle(s) are located. This massage technique was specifically developed after years of working with Olympic and Elite runners to release the scar tissue and create normal function of the muscle and fascia. Self massage will be instructed and will help avoid recurrence.

A running gait analysis will help identify the faulty mechanics in running technique and identify the best shoe for your particular mechanical problems. Phase IV Custom orthotic devices might be necessary. Advice as to the rate of progressing one's return to running is critical and can be developed into a full coaching program to peak your fitness for performance or health.

SPEED-LAB™ - Video & Computer Assisted Run Gait Analysis and Coaching Session.
Efficiency in running means improved performance. We assess your stride frequency, knee rise, foot and leg position at foot strike, and upper body carriage to determine efficient biomechanics. Additionally, state of the art Dartfish™ video analysis software is used, making this the most comprehensive gait analysis available. Shoe changes, limb length correction, exercises, and drills are prescribed to improve efficiency and prevent/resolve injury. You will receive a DVD (PC compatible only) reviewing your gait analysis.

At Forster Physical Therapy we make you an active participant in your rehab and not a passive recipient of our care. We will teach you how to fix yourself with the above-mentioned approach and stay healthy for life!