The cause of shin splints, sometimes used as a “catch-all” term for anterior leg pain, most often can be summed up by this phrase: too much, too soon. Whether it’s a beginning runner adding mileage too quickly or a veteran runner rapidly increasing intensity or dramatically changing their workout routine, the large change in a short period of time does not allow the soft tissues in the anterior leg the appropriate amount of time to adapt to the new stresses and demands.
There are two main locations for shin splints and both will result in pain along the tibia bone itself:
The most common site for shin splints is the the inside of the shin or MTSS. Anterior shin splints (toward the outside of the leg) usually result from an imbalance between the flexor muscles of the calf and the extensor muscles in the front of your leg. Anterior shin splints often afflict beginning runners who have not adjusted to the stresses of running yet or are not properly stretching the lower leg muscles.
There are several theories on the tissue reactions to these increased stresses and muscle imbalances that include small tears in the muscle, an inflammation of the periosteum or the thin layer of connective tissue that wraps around the tibia, an inflammation of the muscle, or some combination of these.
Shin splints often feel worse in the morning or at the beginning of exercise because the soft tissue tightens overnight and at rest. Shin splints are also at their most painful when you dorsiflex your foot and ankle or point your toes toward your head.
Anterior shin pain can also be associated with a couple other, often more serious, injuries, such as a stress fracture in the tibia or compartment syndrome. Symptoms of a stress fracture differ from MTSS in that a stress fracture will typically feel better in the morning and become more painful as exercise continues. There will also typically be a definite point of sharp pain as you press along the tibia or shin bone. Compartment syndrome is a swelling of the anterior leg muscles within a closed compartment of connective tissue, which creates increased pressure in that compartment and compresses the nerves and blood vessels. The symptoms of compartment syndrome include leg pain, unusual nerve sensations, and eventually muscle weakness. Sometimes surgical “decompression” is required if symptoms become severe enough.
The best prevention strategies include a gradual increase in intensity and duration of exercise, wearing the appropriate shoes for your foot type, and proper stretching and foam rolling after exercise.
The standard self-treatment protocol is R.I.C.E (rest, ice, compression, and elevation) or M.I.C.E (movement -pain free range of motion such as light stretching, ice, compression, and elevation). Kinesiotaping can also be beneficial, just make sure you follow the appropriate instructions which can be found here.
Be smart! If you aren’t getting better, get some help. I can’t tell you how many patients I get who wait months or even years before coming in for treatment. The longer you wait, the harder it is to get rid of your symptoms! Here are some tips for finding the right health care professional:
The primary goals of a practitioner using Graston Technique and ART are to:
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