Knee

Shin splint

Bol goleniConsidering all runners’ injuries, a shin splint seems to be the most bothersome and discouraging. The treatment is difficult and the disorder recurs. Post-effort pain in shin may concern not only amateur runners but also experienced professionals.

Diagnose symptoms
The major symptom is the pain around the tibia which is present when making the effort. At first the pain appears at the end of the workout but with time may also occur at its early stage. In extreme cases we feel pain when walking or even resting. In most cases the spot hurts when touching as well. Sometimes the symptoms are also a swelling and subcutaneous protuberance along the medial edge of the tibia.

The injury may be acute or chronic
– acute ailments – periostitis or muscle tendonitis
– chronic ailments – bone micro-fractures, periost weakening

Causes
There are various causes of shin splint, they may be very surprising: workout volume, surface hardness, workout footwear, improper running technique, insufficient warm-up, running at low temperatures, or not enough calcium in our diet. These are external factors.

However it is internal factors that play a key role in this respect: age, sex, previous injuries, inappropriate motor system kinematics, lack of muscle balance, lack of flexibility and muscle weakness, as well as unstable posture.

The latest studies have showed that the shin splint may be a result of inappropriate hip joint functioning. A limited scope of movement in this joint requires a specific type of run, and probably leads to increased load around the tibia. The increased side displacement of pelvis, increased internal rotation in the hip joint and reduced ability to bend a knee also predispose to contract an overburden injury.

Shin-splint 2

What to do when we feel pain?
– rest in acute conditions,
– modify the workout schedule: reduce intensity, frequency and volume, work out with minor load,
– introduce functional trainings which strengthen muscles during rehabilitation,
– gradually return to sport after the pain has subsided
– do regular strengthening and stretching exercises,
– use well-profiled shoes with a sole that perfectly absorbs shocks,
– change footwear and use new ones every 400-800 km,
– use molded insoles if recommended (if the test for forefoot rotation is positive)
– treat the key kinetic chain dysfunctions, apply manual therapy,
– consider other therapy methods: anti-inflammation injections, acupuncture, possibly the surgery.

The injury may be prevented
No fatigue injury is caused by one factor only, it is a matter of interaction of internal and external risk factors. We need to emphasize however that the very factors do not lead to the injury but they raise the likelihood of occurrence. There is one more factor that results in the injury. To create an effective rehabilitation schedule, we need to carry out a bio-mechanical analysis of the run and determine irregularities which cause the aliments to occur.

Anatomy, causes, symptoms and methods of treatment discussed by:
mgr Olga Atraszkiewicz, Rehasport Clinic physiotherapist