If you have ever suffered from “shin splints” you know it! Shin splints is the term given to a pain along the front or back part of the tibia bone in your lower leg. It is common among runners and dancers but does not discriminate against any athlete. In fact, any athlete who has increased their intensity, duration, or frequency in training- especially running- can become afflicted with this condition. Training on hard surfaces, uneven terrain, just beginning a running program, having high arches or fallen arches, military training, and even hiking can all be contributory factors in the prevalence of shin splints.
“Shin splints” is also known as medial tibial stress syndrome and the symptoms associated with this condition are tenderness, soreness, and pain that increases with the activity but can also be painful at rest. With the early onset of shin splints, rest, ice and modified activities are recommended for treatment. That is all well and good but still does not solve the problem. In fact, the problem came on with training and goes away with rest, but who says that it will not come back again when training resumes. This is when a more focused evaluation needs to be done. The sports chiropractic evaluation is a more detailed assessment that looks at all the muscles and joints in the lower extremity to look for imbalances that may be contributing to the problem.
The question arises as to why some athletes are more prone to “shin splints” than others? Like most other conditions there are many reasons as to why one athlete develops shin splints while another does not. Muscular imbalances, overpronation of the foot, or even hip and pelvic distortion can contribute to “shin splints' in one athlete while the more “muscularly balanced” athlete may avoid them. This will be assessed in a sports chiropractic exam.
Two specific deep muscles in the lower extremity known as the tibialis anterior and tibialis posterior muscles are found to be vulnerable in shin splints. They are deep or “core” muscles in the calf and will become weak and imbalanced with repetitive stress and lack of attention. The consequence is “shin splints”. These muscles are tested for strength during the evaluation and more often than not are weak when the athlete has shin splints.
Treatment usually starts with ice and rest. Physical therapy modalities such as ultrasound and muscle stimulation may be helpful to alleviate some of the symptoms. In our practice, I have found that adjusting the tarsal bones of the feet along with performing myofascial release to the deep calf muscles is incredibly effective at restoring motion and function in the lower kinetic chain (the foot and calf region) and reducing shin splint symptoms.
Secondly, the athlete needs to be on a progressive strengthening program addressing all of the muscles of the lower extremity. There should be an emphasis on the superficial and deeper calf muscles.
Finally, the athlete may need a video analysis to assess their overall running mechanics. Once imbalances are pointed out exercises can be provided. This evaluative and therapeutic approach, along with lower extremity, hip, and pelvic adjustments are most effective at healing and preventing future shin splints. The sports chiropractor takes this unique approach to treating shin splints. They will combine traditional methods (ice, modalities, anti inflammatories) with biomechanical evaluation (assessing joints and muscles) and treatments (muscle and joint manipulation with corrective exercise) that are highly effective.
Below are some therapeutic exercises for shin splints. This combined with extremity and pelvic adjustments, myofascial release techniques, and appropriate footwear to support overpronation (sometimes orthotics are necessary) yields the best results!
If you are experiencing “shin splints” consult your sports chiropractor for an evaluation and holistic approach to treatment. Several treatments combined with home instruction will correct the disorder. Diagnostic imaging (x rays, CT scan, or MRI) may be indicated if the problem has been persistent for a long period of time and has not responded to conservative treatment. Your sports chiropractor will only order these if it is absolutely necessary and the patient has not improved with care over 4-6 weeks. Standard protocol is to diagnose with examination, treat accordingly and re evaluate for progress. Results are usually superior to rest and anti-inflammatories alone. Try this multi disciplined holistic approach if you want to not only treat but prevent any future flare ups of shin splints.
William Brightman DC, MS, MEd
Sports Chiropractor/ Exercise Physiologist
Private Practice Mahopac, NY