Squash your shin splints
Hi everyone,
I’m writing to you today with the goal of giving you a little info session on the highly popularized diagnosis of shin splints.
Medial tibial stress syndrome, otherwise known as “shin splints”, is an overuse injury of the lower extremity. When your tibia (lower leg bone) is exposed to rapid increases in load, volume, or high-impact exercise, it may accumulate microdamage in the cortical bone.
One theory is that the pain is secondary to inflammation of the periosteum (fibrous sheath that covers bone) as a result of excessive traction of the posterior tibialis or soleus muscles. Another theory suggests that pain results from bony overload, leading to microdamage and targeted remodeling.
Regardless of the specific pathophysiology of this syndrome, it hurts.
If you’ve ever dealt with shin splints (I had them during my first track season), you know the pain at the medial shin can be excruciating. It makes it difficult to run, jump, and sometimes even just walking is symptomatic.
So… what’s the plan?
In the case of shin splints, “no pain no gain” could not be further from the proper mantra. Because this injury arose from too much load being applied over too short a time frame, the goal will be to offload your lower legs for recovery.
If you’re in the acute phase of this injury (meaning the injury just started), plan on resting for a few weeks. And by rest I mean RELATIVE rest. Don’t morph into your couch cushion, but rather decrease time spent doing the offending activity. If sprinting caused your shin splints, avoid sprinting at this time.
In this period, you can try soft tissue work on lower leg muscles. If ice feels good, you can ice. Basically, do what feels good, stay active, and try not to piss your tibia off.
Once you’ve graduated to the subacute phase of injury, you should be experiencing less pain on a daily basis. This is the time when you can focus on modifying your training conditions and work on more PT specific exercises. For my patients, this might look like:
stretching and strengthening of lower leg musculature (gastroc, soleus, anterior tibialis)
single leg stability exercises
hip and core strengthening exercises
evaluating shoe-wear and making necessary changes if needed
gradual increase in running training intensity and duration
I often get the question “how long will this take to get better?”.
The short answer is - it depends. The severity at which the medial tibia has been stressed, your inherent lower leg strength, the intensity at which you need to perform to return to playing your sport, and your body’s individual recovery timeline will play a role in how quickly you bounce back.
There’s no one-size-fits-all. Imagine that!
With shin splints, the main takeaway should be that this has occurred because you did too much, too soon. And that’s ok! The body just needs time to adapt to the load you’ve decided to place on it, and the pain signals it’s sending you are just a way for it to communicate that it needs some downtime to get used to this new norm.
The good news is, bone will remodel and strengthen according to the stresses we place on it. So once your pain has alleviated and you’ve taken the correct measures to modify your form, strength, shoe-wear, and load tolerance, you’ll have an even stronger tibia than before!
How neat is that?
Now, if you’ve read this and still have questions that need answering regarding your specific injury (whether it’s shin splints or not), click this link to book a virtual consultation so we can spend an hour going over the deep depths of what you have going on.
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Enjoy the rest of your week!
<3 Roni
Medial tibial stress syndrome. Physiopedia. (n.d.). https://www.physio-pedia.com/Medial_Tibial_Stress_Syndrome
