Shin splints is a catch-all term for anterior lower leg pain associated with running. Most commonly the cause is medial tibial stress syndrome – periostitis of the medial margin of the tibia (shin bone) – and this accounts for 50% of lower leg conditions.
The treatment for shin splints is rest. Doctors may prescribe anti-inflamatories and ultrasound may be indicated. Recovery takes from 2-4 months and reintroduction to training activity should be gradual.
It is important to note that pain on medial side of lower leg could also be indicative of stress fracture to tibia or posterior deep muscle compartment syndrome. If symptoms persist or worsen an x-ray is would be required to rule out stress fracture.
Rest from activity is the key to recovery. However, massage can also be beneficial if initial treatment is carried out with caution.
Case study profile
*Male in late thirties
*Generally fit with healthy diet
*Leads a very active lifestyle
*Runs regularly
This runner presented a classic case. He was experiencing an intense local pain - on the lower third of the leg on the anteriomedial (front and inside) surface of the tibia - which diffused up the bone. This ocurred during running and brisk walking and would subside after activity. However, the pain had very recently become more acute and he found that it persisted after training.
The client had been running 8K on pavement monday to friday and, with the onset of the shin pain, had recently invested in new trainers. After an initial improvement, the pain persisted and was more pronounced in the right leg.
A postural assessment showed no obvious biomechanical cause for ’shin splints’, although an old ankle impact injury, which had put him on crutches for three months, might explain why the right leg was more involved. A runner with pronated (flat) feet, for example, might be more prone to this condition. It seemed likely, in this case, that the cause was extrinsic such as training regime, footwear and/or running surface.
Treatment required:
*complete rest from running for at least four weeks - recovery to be monitored
*massage for maintenance and to encourage healing of soft tissue and muscle attachments
*stengthening exercises for associated muscles to improve their capacity for absorbing the stress of running
*exercise, such as swimming or cycling, to maintain general fitness level
*examination of intensity and frequency of training and intention to vary the running surface on return to activity
Conclusions
The rest from running was the key factor in recovery in this case. Massage techniques, including soft tissue release on calf muscles and anterior tibialis, provided immediate relief for the client. This runner was also conscientious with the strengthening exercises (LINK) provided and felt that they made a positive contribution to his return to running. He now varies his routine to include running on a soft surface for at least one run in three.
Client feedback
