Monday, July 8, 2013

Shin Splints: A Mystifying Injury

Anyone who has taken up running as a sport, a hobby or has been dragged into running a 5K has undoubtedly experienced some kinds of shin pain and been diagnosed (through self or medical professional) with "shin splints" but rarely are given a full explanation as to what it is and why it hurts.  Shin pain is generally experienced in one of two locations (sometimes both).  Typically seen in shorter distance runners the pain with be right on the front (anterior) part of their shins and are often times extremely tender to the touch.  The other common location of "shin splint" pain is along the inside (medial) border of the shin.  This is often seen in long-distance runners, anyone who has greatly increased activity, or people who are new to the sport and may have gotten a little over ambitious.

What is a shin splint?
What makes this injury difficult is the multiple issues that could be causing the problem.  The most extreme issues that may be causing you shin pain is an actual stress fracture or other stress injury to the bone.  This is another hard diagnosis as many of them do not show up on x-ray until they actually begin healing, which typically occurs and shows in 2-4 weeks if at all.  If you have the means, often times a MRI or Bone Scan is useful for diagnosing this injury.  Other causes include but are not limited to periositis (bone pain), medial flexor tendonitis, fallen arches, or calf tightness (especially the lateral gastroc). 

What can I do to help?
If this has become a chronic pain and their is extreme pain to the touch or at rest at one specific location along the bone see a physician for further examination.  Many times for runners a simple fix is purchasing a new pair of shoes that are designed with more arch support.  An alternative to this is purchasing a neutral shoe and adding an insert that will increase arch support.  Common sense would think that adding both would be an even better solution but often this leads to over correction of the issue and causes further and unnecessary problems.  Receiving more arch support allows the muscles that run on the inside of your shin (tibia) to go back to their natural position and not be put on excessive stretch as they were without the support.  This is a quick fix to a much larger problem and one that I wouldn't recommend solely relying on but utilizing if it helps keep you going in the short term.

Continue more below:

Calf tightness if often associated with medial shin pain and people will continue to stretch their calves.  The most common lower leg stretch is performed with a straight leg but this does not hit all the lower leg musculature.  This stretch doesn't target the soleous and medial flexors that are underneath the gastroc.  To perform this stretch start like you normally would with a straight leg calf stretch and keep your heal firmly planted on the ground but then bend your knee.  You will typically feel this stretch right above your achilles tendon.  That gastroc muscle does play a role in shin splints though, especially the lateral portion of the gastroc.  When these fibers are shortened and tight they will pull the foot to the outside and cause further stretching and stress on the medial flexor muscles and cause pain.  Soft tissue work and if possible ultra sound treatments are the best way to reduce this tightness and help relieve pain.

While it's an injury that can include several factors many of them are easy to change and fix but the results aren't always instant so give them a little time.  Check out our check list below for helping get on the road to recover with this injury.

1. Hydrate: good hydration allows the muscles to move easier and generally helpful for your body.
2. Work on Running Form: Get it analyzed and coached up by a professional who can look at how you're landing and how good you mechanics are.
3. Tack & Twist: Using a racquet ball or "yoga tune up ball," tap it into the skin around your heel and ankle and give it a quick twist to help release the skin from the underlying tissues.
4. Get the Lower Legs Supple: Get on a roller or a ball and spend some serious time working on all your calf musculature and also the bottom of your foot.  This will reduce stress to the system and allow your body to move much more free.
5. Progress with Care: Don't go 0 to 60 miles, give your body a chance to adapt, it'll thank you later.

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