This article written by City Physiotherapy was originally written for the Business SA Corporate Cup

Shin Splints is a term that is often used to explain shin pain that you may get whilst running or doing exercise that involves running. The medical term we use for shin splints and one that describes the condition more accurately is Medial Tibial Stress syndrome.

Medial Tibial Stress Syndrome occurs quite commonly in runners, dancers, football & soccer players, netball players, gymnasts, high impact aerobics and military personnel. Medial Tibial Stress Syndrome is classified into two types, which affect certain tissues on the inside of your shin.

Type One – Medial Tibial Stress Syndrome

The main feature of this is a stress reaction on the inside border of your shin bone. A stress reaction is the stage prior to getting a stress fracture.

Type Two – Medial Tibial Stress Syndrome

The main feature of Type two is an irritation of the outer surface, called the periosteum, of the inside section of your shin bone. This is the point where the Soleus muscle and Tibialis Posterior muscle attach.

Medial Tibial Stress Syndrome or shin splints is caused by overuse activity. If you run regularly on hard or uneven surfaces you may be at a greater risk of developing shin splints and shin pain. Your overall lower limb biomechanics, such as altered foot, knee and hip position can also predispose you to shin splints and shin pain.

Shin Splints  – What are the Signs & Symptoms?

If you have Medial Tibial Stress Syndrome you will feel pain on the inner border of your shin during and after you exercise. It is important that we assess you so we can assist in determining if you have medial tibial stress syndrome or if you are suffering from other shin pain conditions such as compartment syndrome or a tibial stress fracture.

Shin Splints Treatment – Adelaide City Physio advice

What you can do?

Ice therapy is a good form of pain relief in the early stages of shin pain. The PRICE regime – protection, rest, ice, compression and elevation may assist to relieve the symptoms of your painful shin. Use your ice pack for twenty minutes every two hours. Applying anti-inflammatory gel to the area on your painful shins may also be helpful.

Initially your physio will recommend you rest from the aggravating activity or running. Your hands on Physiotherapist at City Physiotherapy & sports injury clinic may perform a variety of soft tissue techniques to your shin and lower limb. Dry Needling physiotherapy to your shin muscles and directly to your periosteum (shin bone)  can assist in speeding up your recovery.

Our City Physiotherapy Physio’s will then give you strengthening and stretching exercises and will guide you in a gradual return to running after your symptoms have decreased significantly or gone. To prevent the return of your shin splints your Adelaide City Physio physiotherapist may perform a bio-mechanical assessment of your standing posture and during walking and running). From this assessment we can determine if there are any underlying factors which led to you becoming predisposed to getting medial tibial stress syndrome shin pain.

Specific muscle imbalances and leg length differences are also often a cause of misalignment that can be picked up during your physiotherapy assessment. A common cause of medial tibial stress syndrome or shin splints is flat feet  (pes planus ) or pronated foot position (a lowered arch during running). These would be identified during your physiotherapy biomechanical assessment. Pronating excessively is the uncontrolled lowering of the arches of your feet during running. This position creates an increase strain of your Tibialis Posterior muscle resulting in pain. Arch supporting Orthotics insoles may be effective as part of the treatment of this problem.

Your shin pain should be assessed by your physiotherapist as shin conditions can be worsened by continuing to exercise. The best way to maintain your fitness is to perform non – weight bearing exercises in the pool. Running without touching the bottom of the pool is a great way to stay fit whilst allowing your shin splints to recover.

Some patients find that wearing compression gear on their lower limbs helpful. These work by restricting the pull of muscles in the shin, which can reduce the stresses on your shins when you run. They are not a cure for Shin Splints however they may assist in reducing  your painful symptoms. In chronic cases of Medial Tibial Stress Syndrome that do not respond to physiotherapy treatment, surgery may become necessary.

Shin Splints Prevention- What you can do?

You can reduce stress on your shins by wearing shock absorbing inner soles. Medial tibial stress syndrome is caused by exercising or running too much, too soon. If you are starting or changing your exercise program, you should make sure that you do this gradually.

The amount of stress placed on your shins can be decreased by wearing supportive running shoes.