Shin Splints Advice
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A long thin muscle runs along the inside of the shin bone calf, the Tibialis Posterior muscle, which attaches to the medial arch of the foot. If this becomes weak over time, it can make the foot flatter and change the direction of the force applied to the shin bone when walking or running. Continuous overload of the inside of the shin bone causes irritation and inflammation of the medial shin bone, called Posterior Shin Splints.
The symptoms of Posterior Shin Splints include pain to the touch on the lower 1/3 of the inner shin bone. Patients report sharp pain on impact when running or jumping, while there may be a dull ache when walking.
There is rarely any visible bruising to the shin bone, while there may be some mild swelling in severe cases. Walking or running uphill can aggravate the symptoms of Posterior Shin Splints.
Weakness to the posterior tibial tendon is one of the primary causes of Posterior Shin Splints as it results in flattening of the foot and more significant stress being applied to the inner shin. A flat foot can increase the risk of developing Posterior Shin Splints, while a sudden increase in impact activity can also cause Posterior Shin Splints.
Other causes of Posterior Shin Splints include poor footwear and biomechanical faults in someone’s gait.
A Podiatrist or a Physical Therapist can diagnose Posterior Shin Splints in a clinic following a subjective and physical examination based on a patient’s symptoms and tenderness along the medial aspect of the bone. If the clinician is unsure of the diagnosis, they might refer a patient for imaging.
A standard x-ray can rule out any bone stress response, such as a stress fracture, while an MRI can provide information on the bone and the health of the surrounding soft tissues.
Home treatment for Posterior Shin Splints should include reduced time on your feet, including walking and running. If you have mild pain, you can continue to run but take at least 48 hours of rest from impact activity to allow the bone to recover. Icing your shin pain is an excellent analgesic, while non-steroidal anti-inflammatories such as Ibuprofen reduce inflammation in the shin.
Physical Therapy can identify muscular imbalances that may be causing an overload of the medial shin. In contrast, a gait analysis can identify the level of support required from footwear or the necessity for custom insoles.
A thorough rehabilitation protocol should include stretching the calf muscles and strengthening the ankle stabilisers as well as the hamstring and gluteal muscles.
In severe cases, a period in a walker boot of 2-4 weeks may be recommended to reduce inflammation and irritation of the bone before recommencing Physical Therapy.
This is not medical advice and we recommend a consultation with a medical professional such as James McCormack before trying any of these exercises. James offers Online Physiotherapy Appointments for £45.