SHIN SPLINTS

Most people associate shin pain with ‘shin splints’. ‘Shin splints’ also known as Medial Tibial Stress Syndrome (MTSS) are one of the most common musculoskeletal injuries we treat in runners. MTSS is an overload injury which causes generalised pain in the shin. Contrary to popular belief it is actually a bone stress injury and not an overload of the muscles and tissues in the lower leg. Shin pain can be exacerbated by repetitive stress activities such as walking, running or jumping.

If you are experiencing pain that runs alongside the inner shin in a spread out or diffuse pattern, this is most likely associated with MTSS. However, if you have well localised anterior shin pain this should raise suspicion of an anterior tibial stress fracture which is an important differential diagnosis that needs to be excluded.

What causes Shin pain?

At our physio clinics in Dublin 15 and Dublin 24 we specialise in treating runners and other athletes who are affected by shin splints. You may be reading this with Shin pain and think to yourself, well I am not a runner so this doesn’t apply to me. However, bone stress injuries do not discriminate and can affect walkers and social joggers. The most common example we see in clinic is of a patient coming back from a two week holiday, where their walking increased dramatically in a short period of time. Think office worker to Greek Island explorer.

 

Is it Ok to run with Shin pain?

Firstly, it is important to confirm the diagnosis and to rule out some more sinister injuries such as a stress fracture or medial compartment syndrome. We then look to identify and address the main contributing factors leading to this biomechanical overload by adopting four main principles:

Control of training volume:

We aim to find an appropriate level of bone loading that the patient can tolerate. Unfortunately, in some circumstances a period of complete rest from running may be needed.

Strength and conditioning:

We aim to increase the muscle strength to allow for more load tolerance.

MTSS gait retraining:

We use our state of the art facilities to assess your running technique. By altering factors such as step width, step rate and stride length, we can reduce tibial loading and therefore reduce the likelihood of developing shin pain when running.

Gradual re-introduction to sporting activities:

Graded return to running with a comprehensive plan with the sole aim of completing your task pain free