Shin Splints

Painful shins

 

Muscle overuse can cause painful shin splints

Shin splints are a painful injury, common among athletes, soldiers and dancers. They are one of a number of injuries caused by repetitive overuse of leg muscles. Many of those who have sustained injury are unaware of the causes and proper treatment.

There are two ways to look at shin splints: clinically and practically. First, let’s examine the medical basics.

 

What are shin splints?

 

The lower leg is composed of two bones. The tibia (shin bone) and the fibula extend from ankle to the knee. There are eleven muscles in the leg, originating from one of both of those bones. The muscles are encased in four fibrous compartments. Within these compartments runs a neurovascular bundle comprised of nerves and blood vessels. Consequently, muscle movement during exercise is performed in a tight, enclosed space and is bound by a fairly inelastic fibrous retaining wall.

 

Anatomy of the lower leg
Anatomy of the lower leg

There is an elevation of compartment pressure in the leg after exercise. What exactly produces this increased pressure is a matter of speculation. One probable cause is the limit of compartment size, a result of the thickened fascial covering. Another probable cause is the volume within the compartment, a result of enlarged muscle hemorrhage from torn muscle fibers. Prolonged exercise can produce an increase in muscle bulk up to 20%.

 

The American Medical Association defines shin splints as “an inflammation of muscles that lead from the shin to the foot resulting from unaccustomed repetitive activity or forcible use of foot flexors”. The term “shin splints” is used to describe lower leg pain brought on by athletics. This pain includes any combination or all of the following: inflammation of the bone covering (periostitis), muscle inflammation (myostitis), and tendon inflammation (tendonitits). Despite the gloomy sounds of this physiological stat, shin splint victims can take comfort in one thing. Lower leg pain of this type rarely requires surgery.

 

The two most common types of shin splints are Posterior Tibial and Anterior Tibial. With the former, pain extends along the inside or medial back of the lower leg and ankle. With the latter, pain is centered in the lower front of the shin and down the outside or lateral border. Three factors contribute to the overuse of the lower leg muscles: muscle imbalance, running on hard surfaces, and pronated feet.

 

Shin Splints
Common types of shin splints; posterior medial and anterior tibial, referring to location of pain

Treatment

 

The basic treatment for shin splints is RICE – rest, ice, compression, and elevation, accompanied by the appropriate amount of over-the-counter pain relievers to help to lessen pain and inflammation. By the third recovery day begin alternating ice therapy and foot exercises. Deep friction massages before bedtime are also beneficial.

 

The program in “Run through Shin Splints” is roughly as follows:
  1. Walking produces pain (don’t run)
  2. No pain walking (try jogging)
  3. Little discomfort jogging which doesn’t increase with added distance (try running)
  4. After four to six weeks of recovery (try racing)

 

Orthotic therapy can properly align the foot during gait and correct any muscle imbalances that may have been a contributing source of the problem. As well, supporting the arches will reduce any foot pain that has accompanied the shin inflammation. A heel lift reduce strain on overworked lower leg muscles, used in both shoes. Practical recovery from shin splints requires common sense.

 

Prevention

 

Initiating a flexibility and strengthening program for lower legs is an excellent preventative measure. Special attention should be paid to the Achilles tendon, the calf and the tibial muscles, both anterior and posterior. Other ways to prevent shin splints or lessen the pain include running on softer surfaces and using shock absorbing yet flexible shoes. Wearing foot orthotics works as a preventative measure in order to correct two of the factors contributing to lower leg overuse; muscle imbalance and pronated feet.  Paragon offers a variety of device types and styles that can be used as a preventative and/or treatment option for shin splints.

Paragon Sport Orthotic
Functional orthotics for the prevention and treatment of many lower leg issues

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