Shin splints can affect up to 35% of runners, though you don’t need to be a runner to develop this pain. While shin splints are best known as the pain that comes on at the front and insides of the shins during physical activity, shin splints is actually a non-specific term that can refer to three separate conditions:
- Medial tibial stress syndrome
- Exertional compartment syndrome
- Stress fracture of the shin bone
Medial tibial stress syndrome (MTSS)
The most common shin pain of the three above is MTSS, and occurs when there is too much stress to the front and inside of the shin bones. This stress is typically caused by overusing the muscles that attach to the shin bone, or the lining of the bone itself.
While common causes for overusing the muscles at the front of the shins include your foot type (like having flat feet), biomechanical problems in the feet or legs and muscle tightness (like in the calves), this is all exacerbated by running, which places a high demand on the lower limbs. Choosing running shoes that don’t support the feet and legs well during running can also amplify the problem.
The result for runners is shin pain and swelling, that may stay mild, or become severe enough to stop you in your tracks mid-run.
Exertional compartment syndrome
There are four compartments in your lower leg, distinctly separated by your tissues. Each compartment only has so much space to contain specific muscles, arteries, nerves and other tissues.
Damage or overuse to muscles within the front (anterior) compartment means that these muscles swell, increasing pressure within that compartment and resulting in pain or discomfort, a feeling of tightness, and a swollen appearance. As the muscles within the anterior compartment are heavily used during running, these symptoms often start during or after a run.
As the muscles have a chance to rest as you recover from your run, the swelling subsides, and with it your painful symptoms. Unfortunately, they can also quickly recur during your next run.
Note: this type of compartment syndrome is also known as chronic compartment syndrome and requires treatment with your podiatrist, but is not limb-threatening. Acute compartment syndrome, on the other hand, is considered a medical emergency and you must contact your doctor immediately. Signs for acute compartment syndrome include severe pain, pale skin tone at the leg, numbness, a faint pulse and weakness when trying to move the affected leg.
Shinbone stress fracture
Stress fractures are caused by repetitive stress and pressure on the bone, which running definitely plays a big role in, especially when combined with problems with foot posture or function. Starting as small cracks with little symptoms or pain, stress fractures can quickly progress to severe, painful fractures that prevent you from running.
Symptoms include pain and tenderness along the shin bone, that is localised to a particular area. You may or may not see some swelling, and the pain can worsen with physical activity and ease with rest.
It’s important to stop and treat stress fractures before they have a chance to worsen. The earlier the detection and treatment, the easier and faster they are to repair.
Treating shin splints in runners
Effectively treating shin splints starts with having the right diagnosis. When we understand exactly what’s happening and what tissues or structures have been damaged and are involved, we can create a treatment plan to ease your pain, relieve your other symptoms, and then help repair the damage.
To do this, we may use one or a combination of:
- 3D-scanned custom foot orthotics
- Strapping, splinting or bracing
- Footwear adjustment to more stabilising and supportive shoes
- A stretching and strengthening programme
- Gait retraining following a running assessment
- Dry needling to help the muscles involved
Through your treatment, we’ll also be putting the right measures in place to reduce the likelihood of this problem happening again. Our goal is not just to help you right now, but keeping you running safely for years to come!