What are shin splints?
Shin splints are described as pain felt along the front (anterior) or inner (posterior) edge of the shin bone (tibia) which runs between the knee and the ankle. In it’s early stages the pain may only be felt at the beginning of an activity or at the end of an activity, but it may then progress to being present throughout activity, or continually throughout the day.
Anterior shin splints are associated with the tibialis anterior (TA) muscle, whilst posterior shin splints are associated with the tibialis posterior (TP) muscle. Each of these muscles has a tendon which attaches to the periosteum (outer layer) of the tibia bone. Both muscles also have a tendon that inserts in to the bones of the foot and play a large roll in pulling the arch of the foot up.
Shin splints usually occur when there is overloading of either the TA or TP muscles. The tendons pull on the periosteum of the tibia resulting in inflammation in the area. In severe cases the bone can become damaged or even suffer a stress fracture.
What causes shin splints?
As mentioned, shin splints occurs when there is an overloading of the tibialis anterior or tibialis posterior muscles. This overloading can be caused by a number of factors including:
- Over pronation of the feet
- Excessive supination of the feet
- Tight calf muscles or hamstrings
- Increasing training too quickly
- Poor footwear
- Uphill or downhill running
- Running on hard surfaces
- Weak core muscles
Over pronation is one of the biggest contributing factors to shin splints. This is likely because both the TA and TP muscles play a role in pulling the arch up. In a foot that over pronates these muscles are working extra hard to try to pull up the arch.
Tight calf muscles are also a common contributing factor as they act to pull the foot down, which is opposite to what the TA and TP tendons want to do.
How are shin splints treated?
The first line of treatment for shin splints is to reduce the inflammation by means of rest and icing the area. Anti-inflammatory medication may be prescribed. Depending on the severity of the condition, you may need to stop all activities for a period, or you may be able to modify and reduce your activity level to something you are comfortable with.
Stretching and strengthening exercises
Treatment will then involve stretching and strengthening exercises to address and tight or weak muscles. It is important to see a trained therapist to get exercises tailored to your needs.
As over pronation is a common contributing factor for this condition, orthotic therapy is often required to support the arch and control pronation. The individual foot type and activity levels will determine what style of orthotic is appropriate, and whether foot mobilisation is also indicated.
Alter activity to prevent recurrence
Once the shin pain has resolved you will be able to return to activity, but you may need to modify the activities somewhat and ensure you ease in to them gradually to prevent recurrence of the shin splints.