Shin splints are a common pathology suffered frequently by those involved in activities where distance running is prominent. It can however affect any athlete or performer, and even those not involved in sports depending on their lower limb biomechanics.
Medically referred to as Medial Tibial Stress Syndrome (MTSS), shin splints are caused by inflammation to the tibial periosteum, which is the outer connective tissue layer of the bone. This outer layer of bone becomes irritated and inflamed for different reasons. In some cases the anterior tibialis muscle can pull on its insertion points along the bone itself. The reason for this excessive force is due to an overloading of the tibialis anterior muscle during activity. This may occur due to poor trunk position while running (a forward lean), or too big a stride resulting in increased foot dorsi-flexion. Another factor to consider is foot posture, and the presence of excessive pronation (inward turning) of the foot during the contact phase of running. Such an excess of movement places stress on the medial portion of the bone causing discomfort. Other intrinsic factors include weakness of the gluteal and quadricep muscles, as well as imbalances between the core and breathing apparatus. Some extrinsic factors that can contribute to MTSS are; wearing footwear that is not designed for running, worn out footwear and training on hard surfaces.
The symptoms of MTSS are commonly experienced during activity itself whether it be dancing, running or field sports. Pain is experienced on the distal two thirds of the shin bone, with severity dependent on the time spent performing such activities. Pain may also begin to linger post exercise in certain cases. It is thought that severe cases can lead to tibial bone stress fracture.
Physiotherapy intervention will evaluate what combination of factors need to be addressed to prevent or alleviate the symptoms of MTSS. Addressing muscle imbalances is key, as well as correcting any foot postures which may be contributing. Running technique can be assessed by recording your technique using video and a treadmill. Extrinsic factors can be assessed by a thorough subjective examination and implementing some small changes to your training program.
For further advice on shin splints, don’t hesitate to call Bryan at Dunboyne Physiotherapy Clinic.
Bryan Henry, info@dunboynephysioclinic.ie or call 01-524 0496
