Shin Splints

What are Shin Splints?

The term “shin splints” refers to pain along the front of the lower leg, typically affecting the shin area. This condition can be split into two primary categories: muscular shin splints and bony shin splints (also known as Medial Tibial Stress Syndrome, or MTSS).

Types of Shin Splints

Muscular Shin Splints
- Cause: Pain typically occurs in the tibialis anterior or tibialis posterior muscles of the lower leg.
- Symptoms: This type of shin splint involves pain and discomfort in the muscles and surrounding fascia (the connective tissue around the muscles). The pain results from tightness, compression, or damage to the muscles, often due to increased load or calf tightness.
- Common Cause: It is frequently seen in runners and people involved in sports that require repetitive movement of the lower leg. This could be linked to poor ankle mechanics or overuse of the muscles.
Bony Shin Splints (Medial Tibial Stress Syndrome – MTSS)
- Cause: This type of shin splint is related to stress reactions in the tibia (shin bone). It can lead to small fractures of the bone, which may worsen and lead to larger fractures if left untreated.
- Symptoms: Pain and tenderness in the shin area, typically worsening with activity. It is commonly experienced by athletes participating in high-impact sports such as running and jumping.
- Risk: If not managed, it can lead to a chronic overuse injury with potential bone stress fractures.

Causes of Shin Splints

Several factors contribute to the development of shin splints, including:

Rapid increase in training load or change in activity levels (such as starting a new running routine).
Biomechanical issues such as poor hip, knee, or ankle mechanics, which may place excess strain on the shins.
Poor footwear, which fails to provide adequate support, may cause improper foot mechanics and increase the risk of shin splints.
Tight muscles, particularly in the calf, can also contribute to the development of muscular shin splints.

Treatment of Shin Splints

Acute Treatment:
- The first step is relative rest to allow for the reduction of pain and inflammation.
- Treatment may include:
  - Soft tissue release (e.g., massage) to loosen tight muscles, such as the calf and tibialis anterior/posterior.
  - Hot/cold therapy to reduce inflammation and manage pain.
  - Education on how to modify activity levels to prevent further strain on the affected muscles or bones.
Rehabilitation:
- A graduated exercise program will help rebuild strength, flexibility, and endurance in the muscles while gradually increasing the volume and intensity of activity to avoid re-injury.
- Stretching and strengthening exercises for the calf muscles and shin area.
- Proprioception exercises to improve balance and foot mechanics, reducing strain on the shins.
Biomechanical Assessment:
- It’s crucial to identify and address any underlying mechanical issues that may be contributing to the shin splints, such as poor posture or movement patterns.
- Footwear modifications or the use of orthotics may help correct biomechanical imbalances, reducing stress on the affected areas.
Long-term Prevention:
- Gradual increases in training load can prevent sudden spikes that contribute to shin splints.
- Attention to proper footwear and technique can help prevent recurring injuries.
- Consistent stretching and strengthening exercises for the muscles involved in the lower leg, including the calves, shins, and feet.

Conclusion

Shin splints are a common injury, especially among athletes and individuals engaging in high-impact activities. Whether caused by muscle tightness or bone stress, proper treatment—including rest, rehabilitation, and biomechanical adjustments—is essential for recovery. Early intervention and addressing the underlying causes can help prevent future episodes of shin splints and ensure a quicker return to activity. If you are experiencing shin splints, a podiatrist or physiotherapist can guide you through an appropriate treatment and prevention plan.

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