July 23, 2020
Shin splints, otherwise known as tibial stress syndrome is inflammation of the muscles and/ or connective tissue surrounding the tibia- the larger of the two shin bones. It normally presents as dull pain along the front or side of the shins and is worsened by pointing the toes downwards. It is the most common running related injury with an incidence of up to 20% in runners.
Shin splints are usually attributed to overuse or repetitive load through the shin. Risk of shin splints is augmented by multiple variables. A range of intrinsic (individual characteristics) and extrinsic (external variables) factors are at play when we look at the risk of shin splints in runners. Intrinsically, women and individuals with higher BMIs are more likely to sustain shin splints. People with pronated or ‘flat’ feet are at increased risk as their tibia will rotate inwardly when the foot makes ground contact, exerting excessive stress on the connective tissue, eliciting an inflammatory, painful response.
Most risk factors are however extrinsic, empowering the athlete to put prevention measures in place. Sudden increase in duration/intensity of training is closely linked to shin splints as is a cumulative running distance of >20 miles/week. Reduced shock absorption is also a major contributing factor, this may be through running on concrete or in adequate support from footwear. Despite being a soft tissue injury, untreated shinsplints can result in not only increased pain, but they are associated with tibial stress fractures, meaning early intervention is crucial to not only optimising the athlete’s function but preventing complication.
If athletes are suffering from shin splints, the first treatment intervention is a period of temporary rest from the aggravating activity. Along with manual therapy such as deep tissue massage, dry needling exhibits positive results for the treatment of tibial stress syndrome. Long term management strategies include orthotics or insoles to correct biomechanical stresses such as flat feet. A graded return to running also assists runners in avoiding overloading the tissue in the shin, preventing the recurrence of shin splints.