Summer Series - Part 2

June 6, 2019

 Spring is in the air!!!

 

As the weather turns nicer and spring is underway, more folks are exercising with greater intensity and in different environments.

As a result, I am seeing a lot of exercise-related injuries and overuse syndromes in my practice.

In this second part of my summer series, I will discuss shin splints. 

 

What Are Shin Splints???

Shin splints are a common exercise-induced injury. 

Shin splints refer to pain along the inner edge of your tibia bone in your lower leg.

Formally called medial tibial stress syndrome, shin splints are the inflammation of the muscles, tendons and bone tissue around your tibia caused by high impact activity such as running or jumping or repetitive activity that overworks these tissues. 

Runners and dancers are at the greatest risk of developing shin splints.

 

What Causes Shin Splints???

 

Changes in physical activity:  Any sudden change in exercise frequency, duration or intensity can cause shin splints.

Changes in your environment: Any change in the terrain or surface on which you are exercising can cause shin splints.

Foot type: People with excessively flat feet or those with excessively high arches and rigid joints in the foot are at risk for developing shin splints.

Improper footwear: Exercising in shoes that are not appropriate for your foot type, shoes that are old and worn out, or shoes that are not meant to be worn for exercise can lead to shin splints.

 

How Do You Know If You Have Shin Splints???

 

The symptoms of shin splints are:

  • A dull and achy or sharp and stabbing pain on the inside of the lower leg

  • Pain during and after exercise

  • Pain upon touching the inside of the lower leg

 

How Are Shin Splints Treated???

 

If you are experiencing pain that may be related to the development of shin splints, it is important to seek the help of a physical therapist immediately. 

If left untreated, the inflammatory process will continue and may lead to microtears in the affected tissues of the lower leg. 

As with any injury, the earlier the intervention, the better the result and the faster the return to full activity and sport. 

 

 

After performing a thorough evaluation, your physical therapist may do the following:

1.RICE:

a. Rest: It is important to take a break from or modify the activity that is causing you pain.      
b. Ice: Icing the area 2-3 times a day for 20 min will decrease inflammation and pain.  NEVER put the ice directly on the skin.
c. Compression: A compressive bandage or Kinesio tape can help decrease inflammation in the lower leg.
d. Elevation: Elevating the leg will decrease any inflammation that has accumulated in the lower leg.

 

2.  Soft tissue massage: Your PT may use manual soft tissue mobilization techniques to bring blood flow to the affected area to help with the healing of the injured muscles and tendons.

3.  Joint mobilization: Your PT may mobilize the joints of the ankle and foot in order to decrease the stress on the affected muscles and tendons.

4.  Stretching: Your PT may give you stretches for the muscles of the affected leg to improve the mechanics of the lower leg and decrease the stress on the affected muscles and tendons.

5.  Strengthening: Because shin splints often result from overuse, strengthening exercises may be prescribed in the subacute phase of treatment so that the affected muscles and tendons can perform better with more frequent use.  

6.  Cross Train: Your PT will recommend that you “mix it up” and alternate high impact activity with low impact or non-weight bearing activity such as cycling or swimming.

6.  Shoewear recommendations:  Your PT will prescribe the right kind of shoe for your foot type, activity type, and level of exercise intensity. 

7.  Orthotics: In many cases, your PT may prescribe and fabricate custom orthotics to improve the alignment of your foot and ankle, minimizing stress on the affected muscles and tendons.  

It is imperative that before returning to activity or sport, you should be pain-free for ten days to two weeks. 

Additionally, it is important that when returning to activity or sport, you should start at a lower level of frequency, duration and intensity than previously.  This will help to condition the affected muscles and allow them to get stronger gradually in order to avoid re-injury.  

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