Shins Splints (Medial Tibial Stress Syndrome)
Shin Splints: What are they?
Pain is caused by overuse along the tibia, the large bone that comprises the shin. Shin splints, or medial tibial stress syndrome (MTSS), most often occur in athletes who have switched from one sport to another and have not developed a tolerance for high-intensity and repetitive training. This repetitive action and hard training can lead to inflammation of the muscles, tendons, and the thin layer of tissue covering the shin bones, causing pain in this area. Shin splints can also occur when an athlete hasn’t been warming up properly. They are most common in runners, especially long-distance runners, and dancers, such as those in ballet. This injury results in a stress fracture on the tibia, followed by discomfort in the front of the tibia bone, and is the most common complication of medial tibial stress syndrome.
Theory as to why MTSS happens:
According to one theory, this injury puts weight on the skeleton when a lot of activity is involved. The fascia along the tibia’s medial border might be released, allowing easy access to the tibia and adjacent soft tissues while also relieving the strain on the periosteum.
Causes:
Hard Exercise: A sudden increase in exercise intensity, such as transitioning from yoga to sprinting or from playing golf to becoming a dancer.
The Ankle Joint Rolling Inwards: This occurs when the ankle joint, along with the foot you are running on, rolls too far inward just before hitting the ground (overpronation). Overpronation strains your arches and can lead to flattened feet.
Running on Uneven or Hard Surfaces: Incorrect technique or poor running form, like rolling the feet inward (pronation), can strain muscles and tendons. Uneven surfaces, including hills, rough terrain, or concrete, can contribute to this condition.
Using Unsupportive Shoes: Shoes are crucial for your running experience as they play a vital role in ensuring your safety, comfort, and minimizing the risk of severe injuries. Choosing shoes that match your needs for daily activities is essential to prevent injuries.
Prevention:
Analyzing your movement: Analyzing the type of movement you are doing is crucial to understanding how to condition properly for it and avoid injury. A thorough examination of your running technique is important for identifying areas that need improvement. In many cases, a slight change in running form can significantly reduce the risk of injuries.
Avoid overdoing: Being conscious of the current workouts you are doing is essential for understanding what you’re getting yourself into and knowing the associated risk factors.
Adding strength training to your workout: Certain exercises that suit you and your body's needs can help stabilize your legs, ankles, hips, and core. It is beneficial to focus on strengthening your legs for workouts that involve high intensity and strength.
Symptoms:
Aching or dull pain down the front of one or both legs
Shins that are painful to the touch
Pain that worsens during or after exercise
Pain that improves with rest
Pain felt on the outside or front of the shin
Tenderness
Treatment options:
In order to relieve shin splint pain you need to give your muscles and bones to heal as there is high tension on them. Some combinations of healing treatments included:
Rest: take a break from sports and the exercise you were doing to get them. You may need to rest and take it easy for a few weeks longer if needed.
Ice: apply an ice pack to your shins every 10 to 20 minutes, three to around four times a day, for a few days or weeks. Ice is a major factor in helping reduce the swelling and pain of it.
Pain relievers: Over-the-counter medicine (OTC) and nonsteroidal anti-inflammatory drugs (NSAIDs) can ease the pain or any other medications recommended by your physical therapist.
Supportive shoes and shoe inserts: for people who have flat feet this can often be a common occurrence and shoe inserts (orthotics) are often common in these situations as they support your arches and reduce stress on the muscles and bones of the lower leg.
Shin splint stretches: gently stretching and flexing your lower leg muscles may be helpful. Some stretches include:
Kneeling stretch: Get into a tabletop position with your hands and knees on the ground. Grab a foam roller and place it under the tops of your feet. For a higher level of intensity with this stretch, sit back on your hips toward your heels. Hold the stretch for 30 to 60 seconds then return to all fours.
Standing toe raise: Stand with your feet flat on the floor. Rock back onto your heels and lift your toes off of the floor. Hold for at least five seconds then put your toes back on the floor and do two sets of 15
Towel stretch: Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel towards your body, keeping your leg straight as well. Hold yourself in this position for 15 to 30 seconds and relax. Repeat this 3 times.
Seated shin stretch: Sit in a chair towards the edge with your ankles in line with your knees. Take your left ankle and place it on top of your right knee. Place your right hand on top of your left foot, along your toe knuckles. Gently press on the foot to straighten out your ankle and feel a comfortable stretch in your shin and foot. Hold your stretch for 10 to 15 seconds and relax yourself. Repeat this five times on both sides of your feet.
Surgical treatments:
Very few people need surgery for shin splints. Surgery is only performed in extremely severe cases that have not responded to any of the non-surgical procedures. However, it is still not clear how effective surgical treatments for shin splints are. As always, consult a medical professional before attempting any treatment methods.
Sources:
“Shin Splints.” Johns Hopkins Medicine, 8 Aug. 2021, www.hopkinsmedicine.org/health/conditions-and-diseases/shin-splints.
Bhusari, Nikita, and Mitushi Deshmukh. “Shin Splint: A Review.” Cureus, U.S. National Library of Medicine, 18 Jan. 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC9937638/#:~:text=Military%20recruits%2C%20runners%2C%20and%20dancers,or%20have%20hyperpronated%20their%20feet.
professional, Cleveland Clinic medical. “Disease/Condition: Overpronation: What It Is, Causes & Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/22474-overpronation. Accessed 3 Dec. 2023.
“Shin Splints.” Mayo Clinic, Mayo Foundation for Medical Education and Research, www.mayoclinic.org/diseases-conditions/shin-splints/symptoms-causes/syc-20354105. Accessed 3 Dec. 2023.
“Shin Splints - Orthoinfo - Aaos.” OrthoInfo, orthoinfo.aaos.org/en/diseases--conditions/shin-splints/. Accessed 3 Dec. 2023.
“Shin Splint Stretches for Prevention and Treatment.” GoHealth Urgent Care, www.gohealthuc.com/library/shin-splint-recovery-stretches-you-have-try. Accessed 3 Dec. 2023.
“Shin Splints - Self-Care: Medlineplus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/ency/patientinstructions/000654.htm. Accessed 3 Dec. 2023.