Medial Tibial Stress Syndrome, also known as ‘shin splints’, is a common issue treated by physiotherapists. It affects the muscles in the lower 1/3 of the tibia (shin bone). Shin splints are often associated with running injuries. It is more prevalent with long-distance runners, novice runners, increased hill training, and overzealous fitness fanatics. Dancers, tennis players, basketball players, and high divers are often affected by this injury.
Shin splints usually present as a dull ache but the pain may be sharp and severe. Some people have swelling and soreness to touch. Typically, the pain starts at the beginning of the workout, and it may or may not disappear during the exercise. It can return after you finish the workout.
Some of the major causes of shin splints include: changes in running surface and terrain, changes in training regimes, poor foot or ankle biomechanics, poor running mechanics, muscle imbalances, being overweight, or unconditioned athletes doing too much, too fast.
Prior to proceeding with treatment, your healthcare professional will assess you to rule out other causes of the pain. The more serious being stress fractures and compartment syndrome.
Once a diagnosis has been established, a treatment is started. This may consist of heat/ice, ultrasound, and interferential current to control the pain and swelling. Activity modifications will be discussed. Hill running is often discouraged. As well, it is important to identify and correct training errors and abnormal foot biomechanics. Your physiotherapist may try other treatments such as taping or orthotics, and focus on stretching and strengthening exercises. Your doctor may also try to control the inflammation with the use of some medications. If conservative treatment does not appear to be helping, aggressive treatment will usually be attempted. This can include: a total cessation of activity, immobilization of the leg, or, in some cases, surgery, may be considered.
Recovery is often long and frustrating. Shin splints can really interfere with your goals, whether that includes getting back in shape or completing your first marathon. So remember – increase your training at a reasonable rate and slowly make changes in your routine.
Adam Bernard is a physiotherapist working at Dynamic Edge Physiotherapy. If you think you have some of these symptoms, you can book an appointment to see if treatment may be helpful.
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