Shin Splints {part I}

Shin splints have become a catch all term for lower leg pain.

So what are true shin splints? In short, there are two types: Type I is present in the deep compartment of the leg and affects teh tibialias posterior and flexor hallicus and digitorum muscles. The main actions of these muscles are to point the toes downward. Generally Type I shin splints are more acute in nature and cause pain the medial lower leg, this type is also known as Medial Tibial Stress Syndrome. Type II is present in the anterior compartment and affects the tibialis anterior and/or the extensor digitorum muscle. The main actions of these muscles are pointing the toes up. Generally Type II are more a stress/strain reaction stemming from a repetitive motion pattern. This type causes pain in the front/outside of the lower leg.

When something goes awry in the relationship between plantarflexion and dorsiflexion, irritation occurs. The affected muscles can begin to pull away from the bone at the tendoperiosteal junction. This leads to inflammation and irritation of the periosteum (the outer most layer of bone) in the lower leg.

If left unchecked the bone starts to form a stress reaction from the force of the muscle pulling, this stress reaction is typically a precursor to a stress fracture, which everyone wants to avoid.

Generally people experiencing shin splint pain have tight calf muscles. If the calves are tight the ankle can’t do its thing, if the ankle doesn’t work the foot doesn’t work and so it goes and then everything starts pull through the lower leg. So to combat this we work on stretching through the Gastroc and Soleus complexes. Here is an example of how to work through these guys on your own:

After you’ve stretched you want to strengthen. In the case of Type I or MTSS we want to go after the Posterior Tibialias and Flexor Hallicus & Digitorum. If the muscles and bone are irritated, starting with isometrics is a great way to do things. This isometric contraction develops tension without changing the muscles length or joint angle (very low force production). The two muscles are stretched in a vary similiar way, you only change toe curling placement :

And for Type II we go after that Tibialis Anterior. Once you’re comfortable with the isometric strengthening you can move onto resistance strengthening. Bands work great as a start point or you can wrap a light ankle weight around the foot.

A post shared by Dr. Katie Clare (@drkatie_clare) on

So how can you kick shin splints for good? We chat about that next! Stay tuned…

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