Shin Splints
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Shin splints describes pain at the front of the leg below the knee. There can be a variety of causes. The pain usually settles with rest but recurs with activity.
Possible causes
- Inflammation of the periosteum of the tibia (the connective tissue that wraps around the shin bone).
- Stress fracture of the tibia (shin bone).
- Compartment syndrome (inflammation of the muscle which is then restricted and painfully compressed by the fascia or connective tissue that wraps around the muscle).
- Degenerative or acute changes in tibialis posterior muscle.
Treatment
- Rest from provocative activity.
- Ice pack in first 48 hours of discomfort, after this ice or heat by preference. Stretch (see below).
- Address footwear- your foot needs adequate support and shock absorption.
- Low impact exercise e.g. swim, cycle, aqua running in order to maintain your cardio vascular fitness without irritating the problem area.
A physiotherapist can analyse the cause of symptoms and address any biomechanical problems identified.
For example if the hips are not functioning optimally the work load will be shifted to the lower leg muscles which then become painful from the overloading. The physiotherapist can identify the problem areas and help you work on muscular strength and control at the low back, hip, knee, ankle and foot so that the forces are distributed correctly.
You may also be advised on which muscles you need to stretch in order to optimise function in the lower limbs.
Hands on treatment may include release of fascia (connective tissue that envelops the muscles) and correction of movement patterns. You may find your leg strapped or taped in order to alter the lines of pull on the soft tissues.
The physiotherapist may also recommend changing your footwear and possibly the use of orthotics.
The health and integrity of your neural supply (nerves) to the lower limb will be checked to make sure that any compromise is not contributing to pain.
The physiotherapist will then pace your return to activity so that you do not trigger off a repeat episode by going back to training too early or too vigorously.