At some point in your running career you will develop the condition of "Shin Splints." Shin Splints are quite common, but whether common or not, experiencing them can be quite painful. Just when you think your good to go for a long run you begin to experience pain, sometime severe, along the anterior midline to the lateral aspect of the tibial (shin) bone. Research and runner questionaires demonstrate that 15% of all running-related injuries that occur in the United States among all ages of runners is a condition of something called "Shin Splints". Research also demonstrated that one in four people that participate in high impact "Aerobics" which had their genesis in the 80's suffered from Shin Splints. If you have ever had Shin Splints, also known as Medial Tibial Stress Syndrome or Tibial Periostitis, know full well how excruciating the pain can be. Sports and Fitness enthusiasts around the world have tried many different and combined therapies to accelerate healing so that they can enter the fray and begin exercising once again. Treatments include: NSAIDS, ultrasound, whirlpool baths, massage, transverse friction, Graston, electrical stimulation, corticosteroids, and even exercising in a pool. Rest and elevating the aching shins is especially beneficial, but unfortunately most of us, especially athletes, cannot just sit around and rest for very long. Thank goodness that most cases of Shin Splints can be dealt with quickly and effectively.

Dr. Debbie Craig, an athletic trainer at Northern Arizona University in Flagstaff, published an article in a 2008 issue of the Journal of Athletic Training telling us exactly where the pain of Shin Splints comes from. The pain associated with Shin Splints is caused by a, "disruption of Sharpey's fibres that connect the medial soleus fascia through the periosteum of the tibia where it inserts into the bone." Stop for a moment. Take a moments and digest what Craig's research team is saying here. Sharpey's Fibres are the Velcro-like fibers that anchor various tissues to bones. Periosteum is the Fascia-like membrane that covers bones. The aforementioned quote also mentions the fascia of the Soleus Muscle which is the deeper of the two calf muscles. The soleus muscle is also more of a mover and stabilizer of the ankle joint. So the underlying causes of Shin Splints occur in the Fascia and a tissue that would normally be called Fascia, if in fact it is surrounded muscle and other soft tissues covers the bone, and this covering of bone is called the periosteum and if your recall in another article I discussed fascia. What is very important about fascia is that it is heavily innervated with nociceptive pain nerve fibers and as this problem always exists in conjunction with inflammation, then the ongoing result will be scar tissue proliferation. What does this mean? Chronic pain patterns over time abbreviating your running career.

Common causes of Shin Splints:

  • Poor Every Day Footwear: Flats, flip flops and other shoes without heel support and/or cushion fits this description

  • Poor Athletic Footwear: Many running shoes or track shoes have little or no support or are improperly fitted.

  • Working, Living, Playing, or Training on Hard surfaces: Many of us grew up playing basketball, kickball, chase, "tag your it" and other street games. Running on Uneven Surfaces, or longer distance of running up and down hills.

  • Muscle (Agonist/Antagonist) Imbalance: Particularly having quadriceps that are overpowering the hamstrings, or calves that are overpowering the Anterior Tibial Muscles.

  • Weak Core: Strengthening the core and also maintaining or improving ranges of motion.

  • Overtraining: Too much exercise, or too much exercise of one certain kind of exercise creates repetitive stress injuries.

  • Flat Feet or Falling Arches: People with high arches can get them as well but there appears to be less incidence.

Remember: Sprinters rarely get Shin Splints because the anterior tibialis is the decelerator upon heel strike and sprinters run on the forefoot of "balls" of their feet. Joggers and longer distance runners contact the heel to the running surface and this eccentric contraction creates massive stress to the tibia bone and the anterior tibialis as well as the uni-articular soleus muscle causing the tissues to separate, react and inflame.

Shin Splints can typically be completely alleviated within a short period of time, thank goodness for running enthusiast like me, utilizing an extensive post-treatment stretching routine at home and low level laser therapy and transverse/alignment work in our office which literally speeds up "Mother Nature". It is my experience that once Shin Splints are dealt with properly such as dealing with the Fascial Adhesions, strengthening the Anterior Tibial Muscles, stretching out the Soleus, and if warranted fitting the patients into some properly fitting orthotics, they typically have a better chance at not returning. However, keep in mind that any of the above mentioned factors that are not addressed can cause a relapse of the symptoms. Also be aware that Shin Splints and Anterior Tibialis Syndrome can be difficult to differentiate at times so a careful evaluation would be indicated. Give us a call. At the Conklin Clinics we are committed to you and your wellbeing.