Shinsplints are another common running injury. There are two types of shin splints. One occurs on the anterior or front side of the shin and is called anterior tibialis tendinitis. The other occurs on the posterior or back side of the shinbone or tibia and is called posterior tibialis tendinitis. It is very important to address shin pain ASAP as it can progress into either a stress reaction in the tibia or a stress fracture.
Abnormal stresses on the shin that can cause this overuse syndrome include flat feet, high arches, knocked knees, bowed legs, torsional deformities in the tibia and femur, stiffness in the calf and shin muscles, and weakness in the ankles and throughout the lower extremity chain. The onset of shinsplints can also occur with any dramatic change in training routine or pre-season training after a period of inactivity. It is important to understand the principles of proper running technique as well as the weight-bearing forces that can occur during running. You can read more about this in our book The Formula for Running Painfree.
At OrthoWell we specialize in the treatment of running injuries. We are all runners at OrthoWell–so we understand how pain that slows you down or prevents you from running can take its toll both physically AND mentally.
We start the process with our unique bio-mechanical evaluation and video gait analysis to determine HOW things are connected and to determine WHY you are experiencing pain while running. Once we determine the cause of your pain, we will provide you with a detailed wellness plan that will spell out an effective course of action to get you back on the road as soon as possible.
Principles of Healing:
- Activity Modification (Refer to P.R.I.C.E.)
- Specialized Manual Therapy Techniques: Often times there are soft tissue adhesions at the margins of one muscle group relative to another. For example, the attachment of the distal soleus to the tibia as well as the varying layers of soft tissue in both the anterior and posterior compartments of the shin region. During activity, there is a degree of micro-trauma that occurs. This micro-trauma can cause scar tissue. Scar tissue is considered dysfunctional if it binds onto adjacent healthy tissue and prevents normal movement of that healthy tissue. Techniques such as ART, Graston and Cupping Therapy are used to release these adhesions.
- Altered Biomechanical Forces: We can fabricate custom foot orthotics in order to dissipate the shock caused by a supinated foot or the excessive torque created by an overpronating foot. We may also utilize taping and strapping techniques or advise you in the purchase of an ankle brace.
- Stretching: Stretching exercises are used to increase the length and elasticity of your tissues. Overuse syndromes can cause significant stiffness in overactive muscles. We utilize passive and dynamic stretches as well as the neurological principles of reciprocal inhibition to hasten your recovery. We utilize self-mobilization techniques on styrofoam rolls as part of a home exercise program to break adhesion in the anterior and posterior shin soft tissues as well as in the hamstrings and quadriceps.
- Strengthening: Initially, we use Medical Exercise Therapy (M.E.T.) to encourage circulatory exchange and promote healing. M.E.T. is functional retraining of injured tissues and uses low weight and high reps. Repetition is the mother of skill when performing an M.E.T. program. We then progress to functional resistance training and eccentrics using various weight bearing exercises. Eccentrics are contractions in which the muscle elongates against resistance ie slowly lowering your heel off the edge of a step. Scientific evidence supports the use of eccentrics. Please refer to The Missing Link-Scar Tissue. It is also very important to evaluate and address muscular imbalances at the hips and gluteals. Chronic rotational stress syndromes may not improve without adequate strengthening of the hips. Weakness of the hips places greater demand upon the lower leg during weight bearing activities and sports. Muscular imbalances in the hips are common in both the active and sedentary patient.
- Home Exercise Program: The rest is up to you! Compliance with your home exercise program is paramount to a speedy recovery.