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INERTIA: A Therapist's Thoughts

INERTIA

6/18/2009

Shin Splints Uncovered

A reader asked me to write about shin splints in relation to running, an excellent topic and question. Thank you!

Shin splints is a relatively generic term describing pain in the shin area or front of the lower leg. This shin splint pain can have multiple causes that are quite different, some common and others not so common. 

Probably the most common cause of shin splints would be a tendonitis, or inflammation of one of the muscle tendon complexes that attach to the shin bone or tibia. The two most commonly involved muscles being the anterior tibialis and posterior tibialis. Both have extensive attachments to the tibia and overuse or repetitive trauma/stress to these muscles can cause a diffuse but sometimes sharp pain especially with use or running.  

A tibial stress fracture is another potential cause of shin splint type pain. Tibial stress fractures are not rare but not as common as the previously described tendonitis. A tibial stress fracture or reaction is also caused by repetitive trauma or stress, but in this case that microtrauma has caused a small and sometimes difficult to detect fracture in the bone. This is a bit more serious than tendonitis and will require some significant rest and possibly immobilization. 

Lastly, and least common, shin splint pain can be caused by a compartment syndrome. This is when one of the compartments of lower leg muscles develops increased pressure within it which can impair blood flow and ultimately result in significant pain.  

With all cases of shin splints, an appropriate medical examination is recommended to determine what is the cause of the pain. In most cases, physical therapy can be helpful to address issues including stretching overly tight musculature and retraining possible strength deficiencies. In most cases, footwear should be addressed to determine if proper support is present and if a change in running shoe style or possibly the addition of an orthotic (e.g., arch support) is warrented. With most the patients who I see with shin splint pain, a fair amount of time is usually spent addressing the biomechanics of the lower extremity. This usually begins with gait analysis during walking and often running on the treadmill when the patient is able to resume those activities. If you are interested in an assessment of your gait or running mechanics, contact the Sports Medicine Center at 414-805-8656. 



  The following is feedback received for this blog:

Jeff,

Thanks for the article. When I suggested it, I didn't think it would be written that quick. I appreciate your timely response, and hopefully this will help others. I have invested in a quality pair of running shoes, and though I still have pain from time to time, it seems like the pain is not as severe with good shoes. Again, I appreciate the quick response.

Dave
Posted 11:39 AM
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Griffin Ewald, MPT, OCS, CSCS
Griffin Ewald
Physical Therapist
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