Shin splints – the issues and causes

‘Shin splints’ is a fairly dated term now and one that gets used to describe a lot of different issues relating to pain around the shin area. For runners and walkers it’s something that you’ll have almost certainly heard of.

Rather than a ‘single’ problem or issue, shin splints is an umbrella tem and so we’ll split out the issues into separate blogs.

The first covers the one people will probably recognise the most – tibial periostitis.

As you may or may not have guessed from the name, this is the inflammation (-itis) of the outer layer (periosteum) of the shin bone (tibia).

How does it happen?

The foot is supposed to roll inwards as we walk (known as pronation) but this needs to be done in a controlled way. There are key muscles behind the shin and on the back of the fibula (the other bone in the lower leg) that play a role in this, and when they start to fatigue or are put under too much strain, problems can occur.

Foot

This image shows these muscles running underneath the foot to support the arch so it’s easy to see how running or increasing your activity levels can put them under strain. When this happens the medial arch of the foot can ‘collapse’ (not quite as dramatic as it sounds) – pulling the muscles tight against the back of the shin.

If this happens repeatedly (so running, skipping or even sometimes walking) this causes rubbing and friction between the shin and these muscles which will result in inflammation and usually a degree of pain.

How are shin splints treated?

Stretch

In the early stages it’s easy to ignore the signs and just carry on – but the sooner this is treated the better.

If it’s treated early then recovery is usually pretty quick. The first step is rest – the sooner you rest the quicker you’ll be back to exercising.

If it has become particularly inflamed then you may also need to look at icing or doing the stretch shown in this photo. Hold  for 30-60 seconds – once a day is fine, but you can do it as much as you want.

This will usually settle the symptoms, but what about the cause?

Shin splints are often caused when the muscles are too fatigued or simply not strong enough and so strengthening is key.

Initially your focus should be on isolated exercises such as this one before progressing onto more functional, ‘full chain exercises’ such as this and this.

Of course, strengthening does take time to develop so reducing the volume of other exercise will be required, although this is not the end of the world and you will probably be able to carry on with more than you think.

Taping and/or orthotics can also be used temporarily to support the medial arch whilst the muscles have a chance to strengthen up – something to consider if you really can’t hold back too much with training.

In our next blogs we’ll look at the other aspects of shin pain – Chronic Exertional compartment syndrome (CECS) and stress fractures.

 

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