Is Shin Pain Limiting Your Ability To Train, Run or Play Sport?
With the Gold Coast marathon approaching we are seeing an influx of shin pain at the clinic. Shin pain is a very common complaint in individuals who engage in activities that involve running and jumping, particularly (but not always) if their training amount has increased dramatically in a short period of time.
However, what many don’t realise is that there can be multiple causes for this location of pain. Shin pain may be caused by bony stress, vascular insufficiency (poor blood supply), inflammation, increased compartment pressure in the lower leg, local nerve entrapment, or even from another part of the body such as the lower back (amongst others).
Medial tibial periostitis, more commonly known as “shin splints”, is one of the most common diagnoses for the shin. It is a form of stress on the bone in which muscle traction on the shin causes inflammation at the surface of the bone/periosteum.
- Wide spread pain on the medial border of the shin – typically the lower shin but not always.
- Pain pattern that may be felt at the beginning of exercise, but the decreases during exercise and aches again afterwards.
Why is this happening to me?
There are many potential reasons why you may be vulnerable to shin pain:
- Biomechanical issues and the way forces are transferred through the body with running or other activity.
- Shoe choice – may influence running mechanics and how forces are transferred through your body
- Muscular imbalances. For example muscle tightness, weakness or even over-activity of particular muscle groups.
- Decreased bone density.
- Acute change in training habits – for example, rapidly changes from a low load (amount) of exercise to a significantly higher load. This may be as a result of increasing training duration, frequency and/or intensity.
How Should I Manage My Shin’s?
- Check in with your physiotherapist to identify the underlying cause of your pain and the steps that you can take to prevent the injury from progressing along the continuum.
- Complete an initial period of relative rest by modifying training loads alongside acute manage of RICE (i.e. rest, ice, elevation and compression).
- Engage in cross-training with low-impact exercises may be beneficial eg. swimming and cycling.
- Appropriate soft tissue management, muscle strengthening and taping techniques (performed by an experienced health practitioner) can also be helpful during your recovery from shin pain.
Do I need a Scan?
- The best management is to have this injury first seen by a respected health professional.
- If your physiotherapist believes a scan may be of benefit, then this can be organized from this point, or you may be sent back to your GP for further investigation (if needed).
Incorrectly managed symptoms may progress to more serious injuries, for example stress fractures. With this, management becomes different and rehabilitation times generally increase in length. Should your pain become localised, not warm up with activity and continue post-training into the following morning you should most definitely seek advice from your local physiotherapist or GP as soon as possible.
- Bennett JE, Reinking MF, Pluemer B, et al. Factors contributing to the development of medial tibial stress syndrome in high school runners. J Orthop Sports Phys er 2001; 31(9): 504–10.
- Brukner, P. and Khan, K. (2014). Brukner & Khan’s Clinical sports medicine. Sydney, NSW: McGraw-Hill Education.
- Magnusson HK, Westlin NE, Nykvist F, et al. Abnormally decreased regional bone density in athletes with medial tibial stress syndrome. Am J Sports Med 2001; 29(6): 712–15.
- Pell RF, Khanuja HS, Cooley R. Leg pain in running. J Am Acad Orthop Surg 2004; 12(6): 396–404.