What are Shin Splints? - Paul talks Medial Tibial Stress Syndrome
Paul Bellamy is an experienced musculoskeletal physiotherapist located in South Hurstville at Formation Physio. Today he talks about shin splints and how physio can help.
What are shin splints?
Shin splints or medial tibial stress syndrome is an inflammation of the muscles, tendons and/or bone tissue around the tibia. Pain typically occurs along the distal medial border of the tibia where the muscles attach to the bone, but can also occur laterally.
What usually aggravates shin splints?
The pain is normally exacerbated with activities that involve running or jumping particularly on harder surfaces.
What causes shin splints?
Shin splints develop when the muscle and bony tissue (periosteum) in the leg are overworked through repetitive activity.
This often occurs after a sudden increase in physical activity beyond what the tissue is capable of. An increase in activity can be in the form of:
Increased frequency or the amount of times training per week
Increased duration/volume of activity ie. running further/longer per session
Increased intensity of activity
Other factors that can contribute to the development of shin splints include foot mechanics, footwear, running surface and weight.
What are the usual symptoms of shin splints
Shin splints normally present with pain at the mid-lower posteromedial tibial border. The pain normally extends over a 5cm length of the shin. It typically worsens at each moment of contact with the ground.
At first you may only feel the pain at the beginning of a workout and once warm the pain may fade. However as shin splints worsen, pain can persist throughout an entire workout and last for hours or days after exercise.
Common Differential Diagnosis
Stress fractures
Chronic Exertional Compartment Syndrome
Sciatica
Popliteal Artery Entrapment
Muscle Strain
Nerve Entrapment
Common management of shin splints
Our main recommendations for managing shin splints are:
Activity modification
Reduction or removal of the aggravating activity for a 2-3 week period
Strengthening and endurance training of the calf musculature including soleus, gastrocnemius and commonly missed the tibialis anterior
Addressing foot biomechanics
Graded loading exposure program to return to full activity
Running retraining - many people over stride while running, increasing the force through the lower limb per step. We recommend trying to increase your cadence (the amount of strides per minute) aiming to hit 180 steps per minute
Wearing proper footwear
We are here to help 👇🏽
References
Winters, M. Medial tibial stress syndrome: diagnosis, treatment and outcome assessment (PhD Academy Award). Br J Sports Med. 2018
Thacker, S. B., Gilchrist, J., Stroup, D. F., & Kimsey, C. D. The prevention of shin splints in sports: a systematic review of literature. Medicine & Science in Sports & Exercise. 2002; 34(1): 32-40.
The runner´s world editors. Everything you need to know about shin splints. Available from: http://www.runnersworld.com/tag/shin-splints. (Accessed 15/07/2021) Level of evidence 5
Moen, M. H., Tol, J. L., Weir, A., Steunebrink, M., & De Winter, T. C. Medial tibial stress syndrome. Sports medicine. 2009; 39(7): 523-546. (Level of evidence 3A)
Wilder R, Seth S. Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints. Clin Sports Med. 2004;23(1):55-81. (Level of evidence 4)
