Shin splints - a dive into the cause and treatment

Shin splints is a common overuse injury typically found in runners but can occur in any sport with repetitive and standardised loading through the lower limb. Contrary to its name, its does not involve the actual shin splinting, it is a presence of inflammation on the surface of the shin bone (tibia). Its medical name is medial tibial stress syndrome (MTSS) because it is usually found on the inside of the bottom third of your shin bone.

It occurs because of a number of reasons combined and while each person has a different case, the story behind the problem is similar.

  • Sudden change in training load - duration, frequency or intensity of exercise
  • Change in running/training surface or terrain
  • Poor biomechanics - this is a tricky one because not all biomechanical presentations are painful no matter how bad they might be, so you can never assume anything, you must link everything to the pain.
  • Poor strength and joint range is key here. Often high arches and weak glutes are blamed heavily, but its more that the foot doesn't move well, and the person cant access their glute muscles in time for their leg taking their weight.

Let us expland on point 4 a little. On testing, your strength may be great but if you can coordinate this with movement then you will have taken all the load through the leg and shin bone and then onto the other leg all before your glute muscles can control your movement. The brain learns this and so makes your foot more rigid for stability but, this runs at a cost and one of those is shin splints

Unfortunately the best initial treatment is rest.  While most people do this instinctively due to the pain, they are reluctant to do it for an appropriate amount of time. In this period, the most appropriate ice use will help the inflammation a lot too.

You can still train, but if running is the problem, its best to switch this out with a non impact variant such as cycling.  This can be great if you are a triathlete but not co good if you are training for a marathon, but it's not forever - just until the shin’s tolerances can take your training load again.

Your body is giving you fair warning that there is a problem and a change is needed.  If you aren’t doing any strength training (you know who you are!!) then you need to start. No matter what your coach may tell you, interval training and speed work is not adequate strength training. It is really good at highlighting your flaws and potentially giving you problems. Strength training is the exact stuff you probably don't want to do, but it's a necessary tax you need to pay to not only solve the problem but to keep your goals on point. 

Please visit one of our Physiotherapists or Osteopaths if you are struggling with shin splints and would like a further investigation. 

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