Shin pain is a common complaint we see Central Performance, especially in runners. Shin pain is typically referred to as shin splints but this is a poor term to use as it doesn’t accurately describe the different types of shin pain that can present.
The most common shin pain we see in our clinic is Medial Tibial Stress Syndrome. This is pain that presents on the inside of the shin and involves the tibialis posterior muscle. Less frequently we will see pain on the outside of the shin which involves the tibialis anterior muscle.
Stress reactions and stress fractures of the tibia present as more serious forms of shin pain. If the early warning signs of shin pain are not carefully managed, then changes start to occur in the architecture of the bone and a stress reaction or fracture can occur. If someone is diagnosed with one of these injuries it will be a minimum of 6 weeks before they are able to return to any form of running or jumping activity.
There are many potential causes of shin pain but the number one biggest risk factor is a sudden increase in the amount of running or jumping a person performs. Sudden increases in training load put stress on the soft tissues and bones before they can safely handle it. The increased stress on the muscles can cause them to fatigue rapidly and apply pulling (or tractioning) stress to the shin bone (tibia), irritating the bony lining causing inflammation and pain. This can occur in either the tibialis posterior or tibialis anterior muscles we mentioned above. andOver time these tractioning stresses can cause small cracks in the bone resulting in stress fractures.
Poor calf endurance, lack of power and reduced ankle mobility are other factors we look at in addressing shin pain in our clients. The calf has such an important role to play in runners and jumpers and without adequate strength it can lead to excessive loading of other areas around the shin, predisposing the individual to developing shin pain.
Without appropriate ankle mobility the biomechanics of runners can be altered, changing the stresses around the ankle area. Depending on the compensatory gait pattern used to account for this, changes in loading patterns around the shin can occur, excessively loading the shin and causing injury.
At Central Performance your physiotherapist will go through a detailed history of your training to see if there are any underlying factors that potentially contributed to your injury. They will discuss ways in which these factors can be modified to prevent reinjury in the future. A thorough physical assessment will follow where your physiotherapist will describe the details of their findings and the potential contributing factors to your injury. Often a running gait analysis is used. Here you will run on the treadmill whilst being filmed, and your physio will take you through the results of your assessment and outline anything in your technique that may be contributing to your shin pain.
Finally you will be given a detailed plan from your physio. Generally this will consist of a specific strengthening and mobility program based on the findings from your assessment. Hands on treatment will also commence to help reduce your pain and improve any restrictions in your mobility.