SHIN SPLINTS

SHIN SPLINTS

  Shin Splints are common — really common.  They are said to make up about 15% of all running-related injuries that occur in the United States, among all ages of runners.  And get this; one of the reasons that “Aerobics” which were so poplar in the 80’s and early 90’s fell out of favor, was due to the fact that nearly one in four participants developed Shin Splints.  It also happens to be one of the more commonly-seen injuries in the military — particularly in basic training.  If you have ever had Shin Splints (aka Medial Tibial Stress Syndrome or Tibial Periostitis) you know how excruciating they can be. You try all sorts of treatments (ice, NSAIDS, ultrasound, whirlpool baths, massage, electrical stimulation, and even exercising in a pool).  But it seems like the only thing that helps is rest — staying off of your aching shins. The problem is, most of us (especially athletes) cannot just sit around and rest.   Fortunately, most cases of Shin Splints can be dealt with quickly and effectively.

Dr. Debbie Craig, an athletic trainer at Northern Arizona University in Flagstaff, published an article in a 2008 issue of the Journal of Athletic Training telling us exactly where the pain of Shin Splints comes from.  The pain associated with Shin Splints is caused by a, “disruption of Sharpey’s fibres that connect the medial soleus fascia through the periosteum of the tibia where it inserts into the bone.”  Stop for a moment.  Re-read the previous sentence.  Let’s try and digest what Craig’s research team is saying here.  Sharpey’s Fibres are the Velcro-like fibers that anchor various tissues to bones.  Periosteum is the Fascia-like (Fascia-analogous) membrane that covers bones.  The quote also talks about the fascia of the Soleus Muscle — the deeper of the two calf muscles.  In other words, the underlying causes of Shin splints occur in Fascia and a tissue that would be called Fascia (it’s identical) except for the fact that it covers bone instead of muscle (periosteum).  And if you have read my FASCIA PAGE, you are well aware that Fascia is arguably the single most pain-sensitive tissue in the human body.

THE LOWER EXTREMITY AND ITS RELATIONSHIP TO SHIN SPLINTS

Shin splints are usually characterized by pain along the front or inside of the shin bone (depending on which muscle is being irritated — yes, I believe that the problem can sometimes arise from muscles other than the deep calf muscle called the Soleus). The pain will often run clear to the ankle or foot, but nearly always involves the muscles and connective tissues on the inside back of the knee. The pain is usually caused by microscopic tearing and subsequent scarring of these various tissues (see FASCIAL ADHESIONS). Some of the causes of this scar tissue include…….

• Poor Every Day Footwear (flats, flip flops, and any other number of shoes fit this description to a ‘T’)

• Poor Athletic Footwear (Many running shoes or track shoes have little or no support, and many others aren’t nescassarily for the wearers particular foot type)
• Working, Living, Playing, or Training on Hard surfaces — Especially Concrete or Asphalt  (Many of us grew up playing basketball, kickball, and whatever else there is to play on America’s asphalt playgrounds)
• Running on Uneven Surfaces, or lots of Running Up or Down Hills
• Muscle Imbalance (particularly having quadriceps that are overpowering the hamstrings, or calves that are overpowering the Anterior Tibial Muscles)
• Weak Core (Learn more about CORE STRENGTH)
• Overtraining (Too much exercise, or too much exercise of one certain kind of exercise, i.e RUNNING)
• Flat Feet or Falling Arches (This is true, although people with high arches can get them as well)

Shin Splints can typically be completely alleviated in one or two in-office visits, utilizing an extensive post-treatment stretching routine at home.  It is my experience that once Shin Splints are dealt with properly (dealing with the Fascial Adhesions, strengthening the Anterior Tibial Muscles, stretching out the Soleus, and if warranted — getting the patient into some GOOD ORTHOTICS), they do not return. However, keep in mind that any of the above mentioned factors that are not addressed can cause a relapse of the symptoms.  Also be aware that Shin Splints and TIBIALIS ANTERIOR TENDINOSIS can be difficult to differentiate at times.  It does not really matter because the protocol for helping people with either problem is essentially the same.