SHIN SPLINTS

SHIN SPLINTS

Walking, jogging or running is widely accepted as the easiest form of workout. Almost everyone has tried this out some time or the other. Many may have also given it up, mostly due to various aches, pains & soreness complaints!! Amongst the commonest of this may well be ‘shin splints’….

The shin bone is the bone in the front of the leg. Shin splints is a throbbing pain along the shin bone whenever you sprint, jog or put weight on that leg. In medical terms the diagnosis is termed ‘medial tibial stress syndrome’. The pain shoots between the knee & ankle & aggravates with every weight bearing activity. Only in severe cases pain is present at rest also.

Shin splints is grouped under cumulative trauma disorders, which means, a painful condition resulting from constant, repeated, increasing load on the shin bone & muscles around it; without adequate rest periods.

What increases loading across the shin bone??

·         It is no wonder that shin splints are common in people involved in strenuous physical activity. Pursuing moderate to heavy physical activity without sufficient recovery & resting periods seems to be the topmost risk factor.

·         Existing postural deviations in the legs & feet. Flat feet place the most load across the shin bone. Arches in the foot have an important job of maintaining a proper balance between the forces coming from the ground & forces from the leg muscles. Collapse of arches in people with flat feet leads to increased ground reaction forces passing through the shin. Flat feet may not always be painful but they place you at an increased risk for shin splints post extensive activity.

·         Weakness of hip & knee muscles- all the major muscle groups in the lower limb have to work properly to maintain an upright posture against gravity. Weakness in any one group leads to changes across the entire chain of hips, knees & feet. Fatigue post strenuous activities increases this abnormal loads & can cause shin splints.

·         Apart from these physical factors certain external factors are responsible for shin splints, like-

ü  Hard surface (like concrete)

ü  Uneven terrain

ü  Uphill or downhill running

ü  Running on slanted terrains

·         Improper footwear/shoes: ill-fitting shoes can be one of the major cause of shin pain. Wrong shoes change the biomechanics of jogging and running, thus leading to pain.

·         High impact activities performed repeatedly on hard surfaces will surely result in shin splints at some point. This causes a stress reaction in the bone which recovers only with longer rest periods. In severe cases a stress fracture of shin & foot bones is also possible.

·         Sudden increase in intensity of activity/workout. Most shin splint complaints typically start after a sudden heavy workout or a long distance run. Generally rest is sufficient to settle such complaints, but if continued at same intensities; shin splints become persistent. Even things like inclination of the treadmill, increased distance for running, adding a small uphill patch in your normal run, change in shoes; also contribute a lot in development of shin splints.

·         Working out without warm-up or cool down- increases chances of muscle injuries.

·         Obesity- if a person is already predisposed for shin splints due to above factors; obesity adds further to loads already being placed.

Who commonly get shin splints??

ü  Military recruits

ü  Dancers

ü  Runners

ü  Football players

ü  Athletes playing any sport which involves sudden starts & stops (like tennis)

ü  ‘Weekend warriors’ who typically perform intense workouts with no prior training

ü  People with rigid/collapsed arches or flat feet

Credits: REHAB STATION

What to do if I get shin splints??

·         Rest- as the main cause is intense loading due to physical activity, rest is the most obvious treatment! Cut back on your routine workout, stop all high impact activities. Give some time for your tissues to recover.

·         Ice & compression- the next part of the first line management is applying ice & a compression bandage. This will help to settle down any swelling or inflammation in the tissues around the shin bone.

If these do not relieve the pain, it is better to consult a doctor or physiotherapist at its early….

·         Strengthening & stretching of foot & leg muscles- Before resuming previous intensity of activities, a stretching & strengthening program for muscles which maintain arches & alignment of the foot must be started. These exercises have to done in a gradual, progressive manner without triggering pain. Not only foot, but specific knee & hip muscles also need to be targeted.

·         Use of orthotic insoles/ footwear with biomechanical correction- As flat feet are commonly responsible for shin splints, it is better to use footwear with arch supports to prevent recurrences. Entire alignment from hip to toes is maintained properly with corrected footwear. Change of shoes is also necessary if they are worn-out.

·         Start non-impactful activities like swimming or cycling! These activities place lesser/negligible weight bearing stresses & hence can be the best way to maintain endurance, even when having shin splints!

·         Gradually resume your activity with a renewed focus on adequate rest!

Credits: REHAB STATION

HOW WE CAN HELP AT REHAB STATION?
We physiotherapists at REHAB STATION are skilled and experienced in treating shin pain. We have programs designed to manage as well as prevent musculoskeletal conditions ranging from mild to severe degree in all aged population like young athletes, competitive and recreational level.

We use advanced techniques like:

·         Manual therapy interventions like joint mobilization, soft tissue mobilization, kinesiotaping, deep friction and soft tissue massage and neural tissue mobilization.

·         Exercise therapy including progressive resisted exercise using manual resistance, bands, loops, free weights, own body weight, etc.

·         Proprioceptive and balance training with the help of various tools.

·         Electrotherapy (ultrasound, LASER, Cryotherapy, Therapeutic currents)

·         HUBER®360 – a motorised platform with force sensors for functional training and performance enhancement.

Our expert physiotherapy team is focused on making a holistic individualised PREHAB (Preventive Rehabilitation) and REHAB protocols with use of recent evidences so as to have accelerated outcomes. Our evidence-based practice of using therapeutic exercise and neuromuscular routine have successfully rehabilitated several athletes with shin splints with low incidence of re-injury.