Fix Your Shin Splints: Do These Things

Andy Curtiss, BEXSc, NASM - CPT, CES, PES; ACE - CMES; SNC, CNLP

Shin Splints are a condition that effects the anterior compartment of the lower leg. Sometimes it also effects the posterior / medial compartment of the tibia. They can be painful and debilitating. Shin Splints can deteriorate to another condition known as Medial Tibial Stress Syndrome (MTSS), also known as Stress Fractures (Periostitis). They occur often due to a sudden change of impact activities such as going from a sedentary lifestyle to trying to run 5 miles a day. Shin Splints and Stress Fractures commonly effect runners, dancers, soccer players, martial artists and those in sports that require jumping.

IMPACT FORCES AND GENERAL ADAPTATION

Impact Forces are the primary driver behind Shin Splints and this is due to Newton's 3rd Law of motion which states, "Every action has an equal action in the opposite direction." When people perform activities such as running, jumping, and martial arts kicking there is impact between the foot or shin of the person performing the activity and the target or ground. Potential energy or ground impact forces then push back into the implement that struck them. If the body is not adequately conditioned to withstanding the forces exerted upon it, breakdown occurs. This is due to General Adaptation Syndrome or lack there of. Remember that the body is highly adaptive. Even bone can be remodeled to adapt to stress and it does.

CONTRIBUTORS TO SHIN SPLINTS

Shin Splints are the type of injuries that have a broad list of contributing factors. Here are a few:

Running on the toes or the balls of the foot - This can create a direct line of conduction between the ground and the tibia. Toe running can be done without pain, but it requires that the body be adequately conditioned. An alternative to running on the toes and the balls of the feet is using a heel strike in running. Allowing the heel to strike and rolling off the toe is more impact friendly to new runners.

Improper Footwear - Having footwear that does not properly fit or does not have adequate padding can contribute to greater impact forces on the foot.

Improper Jumping and LANDING mechanics - Incorrect landing posture and mechanics can increase the stress applied to the anterior and posterior compartments of the Tibia.

Unconditioned or tight Anterior Tibial Muscles - The Anterior Tibialis, Extensors Digitorum Longus and Hallucis Longus are muscles on the anterior Tibia that control dorsiflexion and the extension of the great and lesser toes. Unconditioned or tight anterior tibial muscles can lead to stress on the anterior tibial compartment.

Tight Calves - Tight or shortened calf muscles of the Gastrocnemius and Soleus can cause an impairment in the ability of the foot to properly go into dorsiflexion. This can become a major contributor of posture distortion, muscle imbalance, and movement dysfunction (IMPROPER MECHANICS).

RICE FOR SHIN SPLINTS

Shin Splints are a good indicator that your body is not adequately prepared to deal with the impact forces it has experienced. The first thing you should do is STOP DOING THE ACTIVITY THAT CAUSED THEM. Shin Splints can resolve in as little as a couple days up to two weeks. When in doubt, seek your physician's care and guidance. Following the protocol of resting, icing, compressing, and elevating can help a great deal when experiencing painful Shin Splints.

RICE PROTOCOL

Rest – Stop doing whatever it was that causes you pain. Rest the injury do not do anything to aggravate it.

Ice – Apply ice to the site of injury. Ice can help to comfort the hot sensation caused by increased blood flow to the area and to reduce inflammation, which will help to reduce swelling and bruising

Compression – Compression can help to ease the pain associated with swelling and aid in the blood flow to the affected area. It can also help to control the swelling. Compression can be achieved by properly bandaging and with the use of over-the-counter splints and braces which have built in mechanisms of compression

Elevate – Elevation is important in the reduction of pain and swelling in that it prevents blood from pooling in the effected area thus preventing additional swelling and reducing pain and throbbing. The limb / injury should ideally be elevated above the heart in order to maximize the hydrostatic effect.

PREVENTION & MITIGATION

Shin Splints are clearly an indicator that there is an imbalance or a lack of conditioning. Best practice for evidence based protocol suggests the following methods for dealing with imbalances, therapy and rehabilitation. When dealing with correcting neuromuscular imbalances corrective exercise specialists, medical exercise specialists, and physical therapists approach the issue using inhibition, lengthening, activation, strengthening, and integration of the effected muscles. I like to use the acronym I-LAST. I-LAST stands for Inhibit, Lengthen, Activate, Strengthen, Throw it all together (Integrate).

Inhibit - Trigger point, Self- Myofascial Release techniques are used to prevent overactive muscles form becoming dominant

Lengthen - Properly stretching overactive and shortened muscles AFTER inhibition techniques are performed can help to restore muscles to normal resting length

Activate - A variety of isometric, callisthenic, and band resisted exercises can be used to activate inactive, underused, and lengthened muscles

Strengthen - Once muscles have become activated and the neurons are firing correctly, they can be strengthened using progressive resistance.

Throw it all together (Integrate) - Integration of an injured muscle or other injury first includes normal activities of daily living, and then can be specialized to sport and occupation specific activities. Integration should be progressive and one should challenge themselves but take caution in not pushing too hard too quickly.

SUMMARY

Shin Splints can be challenging. In the video at the top of this page I go into specific inhibition techniques, stretches, and activation and strengthening techniques to help you get through your anterior Tibial pain. Don't forget to like, share, and subscribe!

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