Blog post 2022- Shin Splints
With Covid still ripe in the community, I have seen an influx of patients who are transitioning their exercise space to being either at home or outdoors rather than in large public gymnasiums. Consequentially, (and perhaps in part due to a few new pairs of Nike’s under the Christmas tree), I have been seeing a sharp increase in the number of patients experiencing ‘shin splints’. This blog post will focus on how and why you get shin splints, as well as some general advice in the management and prevention of this often niggling injury.
WHAT IS IT?
Shin splits aka ‘Medial Tibial Stress Syndrome’ is when additional stress is placed on the front inside part of the shin for extended periods of time and often will involve a degree of increased impact. The most important thing to acknowledge with shin splints is load management – it is often this load that has recently been sharply spiked which has caused the shin splints in the first place. A change in load can come from a few commonly overlooked sources – for example recent increase in running/walking either recreationally or post-surgery, a change in walking surface (footpath to sand), new shoes (different sole density, style, support levels), the change from runners to sport specific footwear (runners to footy/soccer boots with studs) or even repetitive trauma from impact (for example shin strikes in hockey).
HOW DO WE MANAGE IT?
The first step is to take a detailed history and determine where the change in load has come from as outlined above. From here, we will look at any additional biomechanical components that may be contributing (e.g. tight hip flexors effecting gait when walking or running), and then utilise a combination of manual therapy and corrective exercises to get you back on track. In certain situations medication may also be required at which point we would liaise with your GP, however this is not always the case.
Note: very rarely would we ever consider a complete rest from exercises (we do not want to de-condition the entire limb!) – normally you will be safe to continue some gym based strength training, walking within reason, as well as low impact cycling or swimming – this is of course person dependent however.
WHAT CAN I DO TO STOP SHIN SPLINTS OCCURRING?
– If you are going to change footwear, then mix in your new and old footwear. Trial one day old, one day new for the first week or so whilst you ‘wear in’ your new shoes.
– Similarly, when it comes time to pull on the studded shoes for sport, you may consider one night a week still wearing runners for the first couple of weeks.
– Consider a general mobility/recovery routine that includes stretching out the calves, hip flexors and lower back. Suggestions of exercises can be found by viewing our previous blog posts below.
– Complete strength training unilaterally (one sided) – this will help address natural imbalances (although these are still expected to a degree), it will limit ‘favouring’ especially when under fatigue.
– If you are unsure on your technique (whether that be running, cycling, lifting weights), spend the time to train with someone who has the experience to talk you through your specific task. They will be able to pick of on technical errors and steer you in the right direction, improving both performance and decreasing your risk of injury simultaneously– a small investment up front will save you a lot of time and energy down the track!
Finally, if you do find that your shins are sore, you’re limping, you’ve tried resting but whenever you increase the load your symptoms return, then book in to see your local physiotherapist – your load management expert!
Senior Physiotherapist Daniel Browne