Wellness Osteo

Wellness Osteo

At Wellness Osteo, we are osteopaths who focus on achieving optimal health and wellness, which means treating you and sharing our expertise with you. Read on for the ins and outs of osteopathy.

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Shin Splints

Shin Splints

 

What is shin splints?

 

Also called Medial Tibial Stress Syndrome, ‘Shin splints’ is pain along the tibia or ‘shin bone’ and is considered the most common musculoskeletal injury in running and jumping athletes. 

Shin Splints occurs when muscles (usually tibialis anterior and posterior), tendons and bone tissue in the lower leg can’t cope with the load being placed on them by overuse. 

It most often occurs in people who have recently increased the intensity of their training routines, (such as an increase in distance, intensity and duration) or people who are just starting new training after a period of no activity. People trying to do too much too fast.
It is hypothesised that inflammation of the muscular attachments to the tibia, and inflammation to the tibia bone itself, cause a bone stress reaction, and if left untreated can lead to microfractures in the tibia. 

 

Causes:

 

Overuse and new training routines are not the only cause of shin splints. Muscle imbalances, tightness and low flexibility to tibialis anterior, tibialis posterior, gastrocnemius, soleus and plantaris muscles are a big contributor. People with muscle weakness in these areas are more prone to fatigue which will alter your running technique and then cause more strain on the tibia. 


Risk factors for shin splints:
– Running on hard or uneven surfaces
– Poor running shoes that lack support or have poor shock absorbing capabilities.
– Lower leg muscle imbalances
– Obesity 

 

Symptoms:

 

  • Pain in the shin brought on by exercise (running or jumping)
  • Pain increases as activity increases
  • Pain stops at rest or decreases to a lower persistent level
  • Local shin bone tenderness, most commonly in the bottom ⅓ of the shin
  • Pain extends over at least 5cm and is often in both legs
  • Pain is typically present following activity for up to several days
  • Initially you may only feel pain at the beginning of the workout, pain will often disappear while exercising, only to return during the cool-down period. 
  • Pain can be worse in cold weather, so it is very important to warm up properly before activity. 

 

Imaging:


An MRI or X-Ray can confirm a diagnosis of shin splints, but shouldn’t be necessary unless interventions are not working and pain is getting worse. Then imaging can show the difference between shin splints and a stress fracture.

 

Treatment/Management:

 

Depending on the amount of pain a person is in, 2-6 weeks of rest combined with medication (such as non-steroidal anti-inflammatory drugs) and a strength program focusing on the lower leg. 

It is important to understand that rest does not mean ceasing all activity, we just have to modify it so activity is not bringing on any shin pain anymore. No activity at all will be detrimental to your overall fitness and mental health.

Once pain has decreased and is no longer felt walking around, then a slow gradual return to running and jumping can commence.

For example:
If running 2km brings on pain, you should only slowly jog 1km. If that causes no pain, then next time you run, increase the distance to 2km. If it does bring on pain then drop it back to 500m.
Slowly build up back to the point where you can run without pain. 


I have shin splints. How should I manage it?
– Ice packs should be used after any exercise or episodes of pain in the shin for 20 minutes on 20 minutes off until the pain subsides.
– See an Osteopath as manual therapy is also useful to correct any gait (running technique) issues, as well as correcting muscle imbalances and balancing the pelvis, hips and core to take pressure off the lower leg.
– See a podiatrist to get some orthotics and proper running shoes with good shock absorption.
– Exercise on softer surfaces when possible like grass, dirt, sand, synthetic track as opposed to the concrete sidewalk. 

 Surgery is very rarely needed. It is only recommended after the person suffering shin splints has failed one year’s conservative treatment or shin splints has resurfaced more than 2 times.