Shin Splints (Periostitis)

Shin splints is the general name given to pain at the front of the lower leg. Shin splints is not a diagnosis in itself but a description of symptoms of which there could be a number of causes. The most common cause is inflammation of the periostium of the tibia (sheath surrounding the bone). Traction forces occur from the muscles of the lower leg on the periostium causing shin pain and inflammation

Symptoms:

  • Tenderness over the inside of the shin.
  • Lower leg pain which goes after a period of rest but comes back when running starts again.
  • Sometimes some swelling.
  • Lumps and bumps may be felt when feeling the inside of the shin bone.
  • Pain when the toes or foot are bent downwards.
  • A redness over the inside of the shin.

Treatment :

Treatment for shin splints is a simple as reducing pain and inflammation, identifying training and biomechancial problems which may have helped cause the injury initially, restoring muscles to their original condition and gradually returning to training.

What can the athlete do about shin splints?

  • Rest to allow the injury to heal.
  • Apply ice or cold therapy, in the early stages, particularly when it is very painful. Cold therapy reduces pain and inflammation.
  • Stretch the muscles of the lower leg. In particular the tibialis posterior is associated with shin splints.
  • Wear shock absorbing insoles, in shoes. This helps reduce the shock on the lower leg.
  • Maintain fitness with other non weight bearing exercises such as swimming, cycling or running in water.
  • Apply heat and use a heat retainer or shin and calf support after the initial acute stage and particularly before training. This can provide support and compression to the lower leg helping to reduce the strain on the muscles. It will also retain the natural heat which causes blood vessels to dilate and increases the flow of blood to the tissues.
  • Visit a sports injury clinic, for treatment and rehabilitation.

What can a sports injury clinic or doctor do?

  • Prescribe anti-inflammatory medication e.g. ibuprofen. (Always consult a doctor before taking medication).
  • Tape the ankle for support. - A taping worn all day will allow the shin to rest properly by taking the pressure off the muscle attachments.
  • Analyse running style for over pronation and other biomechanical problems of the foot.
  • Use sports massage techniques on the posterior deep muscle compartment but avoid the inflamed periostium.
  • Operate

Important

  • Anti inflammatory drugs along with rest and ice can help reduce inflammation, particularly in the early stages. However if the underlying causes such as tight muscles are not treated through stretching and sports massage techniques then the likelyhood of the injury returning is higher.

FAQ's

Question:
I rest until I have no pain but every time I try to go back to training the pain just comes back again!

Answer:
This is a common complaint. One cause of recurring shin pain is failure to get the muscles of the lower leg in a good condition before returning to training. Tight, knotted calf muscles will increase the strain on the muscle attachments of the lower leg. Regular stretching and sports massage can help make the muscles supple and more effective at absorbing the stresses placed on them. Another cause of recurring shin pain may be poor foot biomechanics. See a podiatrist for a biomechanical assessment if this is suspected.

Shin splints - periostium


Tibialis posterior muscle



Coach Paul