What causes Shin Splints?

Shin Splints describes a variety of non-specific pain that occurs in or around the shin bone (tibia). Usually caused by overuse of the tendon or poor foot mechanics, the pain from shin splints can be located on the bone, the muscle in the front of the lower leg, or the inside of the ankle or arch. Therefore, shin splints in a general diagnosis.

What most athletes call 'shin splints' is better described as Medial Tibial Stress Syndrome (MTSS). With MTSS the pain is felt on the lower one third of the medial or inside part of the tibia. In mild cases, the pain starts immediately at the start of an activity and will gradually decrease once the muscle gets warmed up. In more advanced cases, such as stress fracture, the pain will be a rest, there will be swelling, and an inability to train due to pain.

Where would I feel the pain?

The pain would be most prevalent in the front of the shin. Usually the sharp part of the shin bone, near the ankle or inside of the ankle.

The muscle involved with MTSS is the Tibialis Posterior. This muscle originates along the border of the tibia (shin bone) to just above the inside of the ankle bone where it becomes a tendon. The tendon then continues down and inserts in to arch bones.

What causes Shin Splints?

Improper training (usually increasing mileage or increasing intensity too quickly) may cause the tendon to tire without enough recovery time. Another major cause of MTSS is improper foot/leg biomechanics. This may include too much pronation (arches falling) or not enough pronation (high arch). With excessive pronation, the dropping of the arch will overstress the Tibialis Posterior, whose main job is to maintain arch support and lift the heel during running and walking. With a high arch, the Tibialis Posterior tendon is already under stress as it is tight from the characteristics of the high arch. With the added stress of increased activity, such as running, there is too much demand on the Tibialis Posterior causing MTSS.

Improper footwear can be a factor in your injury. Your footwear must match your foot type and take into account your individual activity and mechanics.

What can be done to treat Shin Splints?

Custon Foot Orthotics and proper footwear can help correct poor foot mechanics after an evaluation by a Canadian Certified Pedorthist. Athletic Therapists and Physiotherapists use exercise and modalities to resolve muscle imbalances and decrease inflammation. Cross training is an excellent way to train to reduce the stress on your shin splints. It is said that 20 minutes of running in a pool produces the same aerobic effect as one hour of running on the roads. For a change try riding a bike. An excellent way to ride during the winter months is to join a 'spinning class'. Finally, the best way to look after your MTSS is to ice and rest your legs. Massage also assists in breaking down scar tissue and promoting circulation. Ignoring shin pain can lead to the development of stress fractures and recovery from that may take up to 6 weeks.

Simple Stretches to help prevent Shin Splints

1. Standing Stretch - With your feet together, step back with one foot and bend your front knee. Rest your hands above your front knee, centre your weight and push your back heal into the floor. Hold the position for 30 seconds and repeat.

2. Sitting Stretch - Sit on the floor and bend one knee holding the ball of your foot with both hands. Pull back on your toes as far as possible and hold that position for 30 seconds. You should feel a stretch along the underside of your foot and lower leg. Repeat.

3. Circle Time - Sit with one leg extended straight out and one leg bent so that your foot rests on top of the opposite thigh. Gently press one hand down on the inside of the bent knee. Then point, flex, and make circles with your foot. This is a great exercise for shin strengthening and will help you gain greater range of motion and better circulation.

4. Foot Scrunch - Sit on a chair or low stool, knees bent with a towel beneath your bare feet. Use your toes to scrunch to towel towards you. As you get stronger at this exercise, add weights to the edge of the towel to make this exercise more challenging. Repeat for 15 minutes.

5. Step Downs - With both feet on a ledge or stair, bend your right knee until the toes of your left foot reach the floor. Return to starting position and repeat 10-15 times. Then switch sides.

6. Step Ups - Standing on a ledge or stair with your heels hanging off the edge, shift your weight to the ball of your left foot and lower the heel of your right foot. Slowly raise your right heel. Now balance your weight on the balls of both feet and raise both heels upwards. Slowly lower your heals. Repeat 15-20 times.

7. See your Pedorthist for good orthotic support and recommendation of proper footwear.