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Shin Splints! What They Are And How to Fix Them

What are shin splints?


Shin splints is used as an umbrella term that covers a variety of conditions that affect the shins (Tibia). The term shin splints can include connective tissue inflammation surrounding the tibia, issues with nearby tendons, bone stress reaction injuries of the tibia and a handful of other tibia related injuries.


Typically the majority of patients we see in clinic with “shin splints” actually have a condition called Medial Tibial Stress Syndrome (MTSS). MTSS is caused by chronic traction of soft tissue structures that connect to the tibia usually due to repetitive impact or high impact loads. MTSS usually develops at the lower one third of the tibia, this is where the bone is at its most vulnerable to high loads and impact forces.


What causes shin splints?


Shin splints or MTSS is an overuse injury, like all overuse injuries there are a number of risk factors that can contribute to injury. Some of which include:


  • Weak calf muscles
  • Tight calf muscles
  • Rapid foot pronation (flat feet)
  • Weakness through proximal structures such as glutes and core
  • Sudden increases and spikes to training loads
  • Changes in training/running surfaces
  • Hill sprints or stair climbs
  • Poor footwear selection
  • Poor running technique (most commonly over-striding)
  • Excess body weight


Typically we will see at least three of these risk factors in patients experiencing MTSS.


How do I know if I have shin splints?


The classic symptoms of MTSS are tenderness down the lower third of the shin and pain along the inside section of the tibia.Symptoms tend to worsen over time and with increased stress and load to the area.


A mild case of MTSS may only be tenderness down the tibia to touch but as the condition progresses it can cause pain during activity and even develop to the point of pain after activity and during rest (chronic aching).


How can I fix my shin splints?


1. Unload the bone and the tissue


The most important step is to decrease the load (forces) being placed on the injured structures. This mean rest and getting off your feet. The inability to do so may lead to a worsened condition and possibly even to stress fractures of the tibia which can put you out of action for a prolonged period of time.


When we talk about rest we don’t want complete inactive rest, we want active recovery. This means changing your forms of load with other types of activity. This can include swimming, water running, cycling and rowing to decrease the impact loading going through the affected structures.


2. Fix the causative factors that has led to the injury


This step will help stop the injury from returning and plays a major part in the rehabilitation of the condition. If you just rest and do not address the factors that have caused the problem in the first place, it is extremely common that the condition will return.


This is where a skilled health practitioner can help you:


  • A) identify areas of concern and risk factors that have lead to the overuse issue
  • B) put and action plan in place to help correct and permanently fix your pain.


In our experience there needs to be a holistic approach to treatment of MTSS. Some of the modalities we use to heal MTSS can include:


  • Running analysis and gait retraining
  • Exercise prescription and muscle strengthening to increase load capacity
  • Stretching restricted and stiff tissue
  • Taping to help offload and protect injured structures
  • Modifying your training loads and activities to ensure you maintain your aerobic capacity
  • Footwear prescription that is bespoke to your needs
  • Orthotic therapy to help address your foot mechanics to optimise efficiency


When can I return to my regular activity?


Once you have given the injured area adequate rest and have put in action a rehab plan it is now time to start gradually reintroducing your loads. It’s important that we slowly progress your training and activity load with a 10 – 20% increase week to week moving forward. This will build up the injured areas load capacity slowly so that you can now go longer and harder than before.


If you think you may be suffering from Shin Splints book online with us so you can get back on track to achieving your goals.

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