Shin Splints … explained by Jacob

Shin Splints is one of those common terms that gets thrown around quite often … much like Sciatica and Plantar Fasciitis … and as Remedial Massage Therapists we hear allot of self-diagnosis with these conditions. So let us take a deeper look into what Shin Splints actually are, how it can affect you and what can be done about it, so you can better describe your symptoms to your treating therapist and not fall into the trap of describing all lower leg dysfunctions as shin splints.

What are Shin splints?

Shin Splints is a term used to describe pain in the lower leg around the Tibia (the larger of the 2 bones in the lower leg) between the knee and ankle. Also often called Medial Tibial Stress Syndrome (MTSS) or Anterior Tibial Stress Syndrome (ATSS) depending on the region affected.

Pain generates from the muscles and tendons running the length of the Tibia pulling on the bone, causing inflammation as a result. Pressure caused by the muscles and tendons can create small micro fractures throughout the Tibia, causing yet more pain and inflammation.

If left untreated shin splints can develop into muscle compartment syndrome – A serious condition in which the muscle becomes engorged, and the fascia surrounding the muscle restricts its expansion. This can cause restriction to blood flow in the muscles of lower leg … more pain develops, and you can even experience some loss of sensation or failing of the muscles when in use.

How does Shin Splints occur?

Shin Splints can occur in a range of different ways.

•  Overuse of the muscles is the most common way. This can be from a sudden increase in your training routine which you may not have worked up to just yet … like a large increase in running distance when you decide to run your first Marathon or Fun Run for example.
• Incorrect running technique can also be a cause of shin splints. When we run incorrectly the forces from the impact on the ground do not disperse throughout the foot correctly and create uneven forces through the leg.
• Weakness in your foot arches can also cause uneven distribution of forces throughout the leg, and old, bad, or ill-fitted footwear will do much the same.

How is it treated?

As Shin Splints is most commonly a muscular issue, if you are experiencing aches and tightness during or after exercise the usual Rest, Ice, Compression and Elevation (RICE technique) should help ease some pain and swelling.

However, when the pressure from the muscles has caused fractures along the Tibia, a more involved rehabilitation program is usually needed. These programs can vary widely based on the client and specific presentation of pain and inflammation but will most likely involve a period of non-weight bearing, followed by regaining your range of motion, then muscle strength and finally returning to exercise. This process will vary in length depending on the client although, generally speaking, the average recovery time would range between 4 weeks to 3 months.

When Shin Splints have developed into muscle compartment syndrome (which is an extremely serious condition) occasionally surgical intervention is necessary. This procedure is called a Fasciotomy or Fasciectomy and involves cutting the fascia surrounding the muscles – along the length of the muscles – to decrease the pressure from the engorged muscle. As I am sure you can imagine, surgical intervention comes with its own rehabilitation programs which will be prescribed by the associated health professionals.

How is Shin Splints Diagnosed?

Shin Splints is usually diagnosed after a review of your medical history and a physical examination from a physiotherapist or GP. Medical imaging such as X-ray or MRI can also be useful to identify the structures involved and confirm/deny the presence of fractures throughout the Tibia for more severe shin splint. If you suspect you may be suffering from Shin Splints seek advice from your GP or physiotherapist.

How can massage help?

Here at HANDS from HEAVEN we can help ease some tension through Remedial Massage and Fascial Stretching techniques. We can also show you some techniques to self-massage from home using a foam roller which can be a great tool if you are not able to make it into the clinic. It is very important to keep in mind that although you may get some much-needed relief from massage, Shin Splints can be a serious condition that needs to be treated by a medical professional.

Conclusion

When coming in for a Remedial Massage it is important to describe as much about your symptoms as possible. This can help us identify the correct treatment methods to help with your pain and any associated muscle dysfunction.

Preparing a quick description of your symptoms before coming into the clinic may also be useful. Here is a list of some questions that may help you better describe it to your therapist.

• Is it pain or tension?
• Which area do you feel it?
• How long has it been happening?
• Does it get worse with exercise?
• Does anything help ease the pain/tension?
• Does it feel like a sharp pain or dull ache?

These simple questions can help your therapist narrow down a potential cause and in turn the best treatment options for you.

Ultimately the ideal way to prevent shin splints would be slowly increasing your training routines. It can be very tempting when on a weight loss or fitness journey to jump straight in and go all out in the first few weeks, but always keep in mind that it is not a race but a long journey and slowly increasing your training as your fitness increases will help prevent not only shin splints but a whole wide range of injuries.

Of course, at HANDS from HEAVEN Remedial Massage we are always here to help when you need it and getting regular treatment as you progress on your fitness journey will help you avoid unnecessary pain or injury.