Most of us have heard of shin splints, but I’ll bet than many don’t really understand what shin splints are. Typically if a patient describes pain in the front of the lower leg, it will be diagnosed as shin splints. Let’s talk about the causes and treatment of this condition.
This condition is common in people who do a lot of running, as well as with people who have jobs that involve excessive standing or walking. The pain is typically felt in the front of the lower leg bone, the tibia. It is often described as a throbbing pain, or a deep ache, but also can produce sharp pain as well. The interesting thing is that although the pain feels as if it is coming from the bone, it is typically produced by the soft tissues that attach to the bone. This includes the tibialis posterior muscle, which is attached on the posterior (back) side of the tibia bone. This muscle is active whenever we are bearing weight on our leg. It helps to keep the arch of our foot from collapsing during weight bearing. People who have flat feet/arches would be more prone to developing this condition, as the tibialis posterior muscle will work hard to try to support the collapsing arch.
In terms of treatment, there are a couple of things to consider. First, a precautionary X-Ray or bone scan is often a good idea, as repetitive stress on the shin (especially in long distance runners) can lead to a stress fracture. If this is ruled out, then we treat the soft tissue problem. As always, we want to identify the cause of the problem, not just treat the symptoms. Patients can take anti-inflammatory meds, or ice the painful area, but these will only provide temporary relief and will not address the cause of the pain. We first need to look at the lower leg and foot alignment to see if an orthotic is indicated. If a patient has poor foot structure (especially flat arches, but sometimes excessively high arches), a shoe insert to support the arch can relieve stress from the lower leg muscles (tibialis posterior) that have to work excessively to support the arch. We also want to make sure that the patient has full range of motion and flexibility in the lower leg/ankle/foot region, as well as good muscle strength in the lower leg/ankle/foot region. A gait evaluation and possibly a running assessment are also indicated to identify abnormalities which may be contributing to the condition.
If you have been dealing with shin pain, please give us a call so that we can help you! This can be a difficult condition to treat, but it is treatable, especially with the help of an excellent physical therapist.
By: Mason Riegel, PT
Steve Bartz, PT