What is Shin Splints?
Shin splints, also known as medial tibial stress syndrome (MTSS), is a common overuse injury that causes pain and discomfort along the front of the lower leg, specifically around the shin bone (tibia). The pain is typically felt on the inside of the shin, where the muscles, tendons, and bones meet.
The most common cause of shin splints is overuse, particularly in people who engage in sports or activities that involve running or jumping, such as track and field, soccer, and basketball. The repetitive stress of these activities can cause inflammation and small tears in the muscles and tendons that attach to the tibia, resulting in pain and discomfort.
Other risk factors for shin splints include:
- Wearing worn-out or improperly fitting shoes
- Having flat feet or high arches
- Having tight calf muscles or weak ankle muscles
- Running on hard surfaces or uneven terrain
- Sudden increase in the intensity or duration of physical activity
The symptoms of shin splints may include pain and tenderness along the front of the lower leg, swelling, and muscle soreness.
Treatment options for shin splints include rest, ice, over-the-counter pain medications, physical therapy, and orthotic inserts. It is also important to address the underlying cause, such as by changing shoes, modifying training routine or changing the surface of the activities. Gradual return to activity is also crucial for a full recovery.
Common symptoms of Shin Splints
The common symptoms of shin splints typically include pain and discomfort along the front of the lower leg, specifically around the shin bone (tibia). Here are some other symptoms you may experience with shin splints:
- Pain that is felt on the inside of the shin, where the muscles, tendons, and bones meet. The pain may be dull or sharp and can be aggravated by activity.
- Soreness or tenderness to the touch along the shin
- Swelling or redness in the affected area
- A dull ache that persists even when you’re not active
- Tightness or weakness in the muscles of the lower leg
- Stiffness in the leg, particularly in the morning or after sitting for long periods
- Cramping or muscle spasms
It’s worth noting that the symptoms of shin splints can also be similar to those of other lower leg injuries, such as stress fractures, so it is important to see a medical professional for an accurate diagnosis and appropriate treatment.
Causes of Shin Splints
Shin splints, or medial tibial stress syndrome (MTSS), is caused by overuse or repetitive stress on the muscles, tendons, and bones in the lower leg. Some of the most common causes include:
- Engaging in sports or activities that involve running or jumping: Shin splints is a common injury among runners and athletes who participate in sports such as track and field, soccer, basketball, dance and many more activities. The repetitive impact of running or jumping can cause inflammation and small tears in the muscles and tendons that attach to the tibia, resulting in pain and discomfort.
- Wearing worn-out or improperly fitting shoes: Poorly-fitted shoes that don’t provide enough support can lead to shin splints. Worn-out shoes can also cause problems because they lose their ability to cushion the impact of each step, which increases the stress on your lower legs.
- Having flat feet or high arches: Flat feet or high arches can cause excessive strain on the muscles and tendons in the lower leg.
- Having tight calf muscles or weak ankle muscles: Tight calf muscles can limit your ankle’s range of motion, which can increase the stress on your lower leg, weak ankle muscles can also cause overcompensation in other muscles, leading to imbalance and risk for injury.
- Running on hard surfaces or uneven terrain: Hard surfaces like concrete can increase the impact on your lower legs, running on uneven terrain can cause extra strain to your leg muscles.
- Sudden increase in the intensity or duration of physical activity: If you increase your physical activity too quickly, it can put extra stress on the muscles and tendons in the lower leg, leading to shin splints.
It’s worth noting that these are the most common causes of shin splints, but there may be other factors that contribute to the development of the condition. It’s important to see a medical professional for an accurate diagnosis and appropriate treatment.
How is Shin Splints assessed by a Physiotherapist?
A physiotherapist will perform a thorough assessment to diagnose and treat your shin splints. During the assessment, the physiotherapist will gather information about your medical history, symptoms, and any previous injuries you may have had. They will also ask you about your level of physical activity, including the type of activity, intensity, duration, and frequency.
The physiotherapist will then perform a physical examination, which will include a number of tests to evaluate the range of motion, strength, and flexibility of your lower leg. They may also observe your walking and running gait to look for any abnormalities or compensations that could be contributing to your pain.
The physiotherapist may also perform special tests specific for shin splints such as the squeeze test or resisted dorsiflexion test. The squeeze test is where the therapist will squeeze the calf muscle and ask the patient to experience any pain along the shin, and the resisted dorsiflexion test is where the therapist will resist the ankle movement towards the toes and ask the patient to report any pain along the shin.
The physiotherapist will then use the information gathered during the assessment to make an accurate diagnosis of your condition and to develop a treatment plan tailored to your specific needs. The treatment plan may include a combination of techniques such as manual therapy, exercise therapy, taping, ultrasound, and electrotherapy, and to address the underlying cause of the injury.
It’s important to understand that physiotherapy treatment should be specific to the individual patient. Your physiotherapist will adjust the treatment as they see your progress, to ensure that you are receiving the most appropriate care for your condition.
Treatment for Shin Splints
Treatment for shin splints typically includes a combination of techniques aimed at reducing pain and inflammation, improving muscle strength and flexibility, and addressing the underlying cause of the injury. Here are some common treatment options:
- Rest and ice: The initial treatment for shin splints is typically rest and the application of ice to the affected area. This can help to reduce pain and inflammation. It’s important to avoid activities that aggravate the symptoms until the pain subsides.
- Physical therapy: A physiotherapist can develop an exercise program to help you regain muscle strength and flexibility. This may include exercises to target the muscles of the lower leg and core, as well as stretching exercises. Your physiotherapist will teach you how to perform the exercises correctly, and monitor your progress over time to make adjustments as needed.
- Orthotic inserts: If the cause of shin splints is related to foot mechanics, such as flat feet or high arches, the physiotherapist may suggest orthotic inserts to correct the problem and to prevent reoccurrence
- Taping: Your physiotherapist may use tape to support the muscles and tendons and help to reduce pain and inflammation. This method is used to provide proprioception (awareness of the position of one’s body) and support to the affected area and usually used in conjunction with other techniques.
- Manual therapy: The physiotherapist may use manual techniques, such as massage and mobilization, to help reduce pain and inflammation, and improve muscle strength and flexibility.
- Medications: In some cases, the physiotherapist may suggest the use of nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce pain and inflammation.
- Gradual return to activity: Gradual return to activity is crucial in preventing reoccurrence of the shin splints and ensuring full recovery, your physiotherapist will guide you in how to progress your activity level, and provide you with the appropriate level of exercises that you need.
It’s important to note that the treatment plan will be tailored to your specific needs, and the physiotherapist will adjust it as they see your progress. It is also important to address the underlying cause of the injury to prevent recurrence, so that it’s not just treating the symptoms but fixing the root of the problem.
Dangers if left untreated
If left untreated, shin splints can lead to a number of complications. Here are a few examples:
- Chronic pain: Shin splints can cause chronic pain in the lower leg, which can make it difficult to perform everyday activities and can negatively impact a person’s quality of life.
- Reduced physical activity: The pain and discomfort caused by shin splints can prevent a person from participating in physical activity, which can lead to muscle loss, weakness, and decreased cardiovascular fitness.
- Stress fractures: When the symptoms of shin splints persist over time, it can increase the risk of developing stress fractures, which are small cracks in the bones. These fractures can be serious and may require surgery to heal.
- Chronic injury: If not treated, shin splints can become a chronic problem, recurring every time a person increases their level of physical activity. This can lead to a cycle of pain, rest, and reduced activity, which can have a significant impact on a person’s quality of life.
- Chronic disability: When shin splints are not treated and progressive, it can lead to chronic disability and affect a person’s work and personal life.
It’s important to seek treatment as soon as possible if you suspect you have shin splints. A physiotherapist or medical professional can help determine the underlying cause and provide appropriate treatment to help prevent complications. Also, treating the underlying cause, such as muscle weakness or poor foot mechanics, is crucial to prevent recurrence of the injury.
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