Shin Splints (AKA: Tibial Stress Syndrome)
What is it?
MTSS (shin splints) is a clinical pain syndrome involving an overuse injury of the lower injury. Pain is typically along the back and inside portion of the tibia that is exercise induced or activity related.
Medial Tibial Stress Syndrome exists on a continuum where the more running that occurs can cause pain which requires activity modification and strengthening. If not addressed, this can progress from just pain all the way to a stress fracture.
Patient Education to avoid Re-Injury
Acute Phase:
Active rest, ice, NSAIDS (ibuprofen), and even crutches to normalize gait pattern if severe .
Subacute phase:
Decrease running distance, intensity, & frequency by 50%.
Cross-train with other low-impact activities such as swimming, running on softer surfaces, or biking.
Proper footwear: implementing shock absorbing soles and insoles and changing shoes every 250-500 miles.
How Physical Therapy Can Help? Graded Exercise, Bone Strengthening, & Muscular Strengthening
A gradual return to exercise is crucial in preventing MTSS from reoccurring. Graded Running programs help strengthen the tibial cortex, and progressive loading promotes further bone remodeling.
Reduce and scale back any activities that exacerbate symptoms/pain.
Slowly increase training intensity & duration.
Incorporate sport-specific exercise & loading! Ex: Hill running, jumping activities (all of which remains PAIN FREE).
Muscular Strengthening: Inadequate load absorption running is a key contributing factor to MTSS; therefore strengthening the necessary musculature helps reduce the stress the bone takes with running.
Special Emphasis on:
Gastroc/soleus complex, flexor digitorum longus, tibialis anterior/posterior, and fibularis muscles to increase control and load absorption will better dissipate forces to the tibia.
Trunk and Hip Stabilizers: abdominals, gluteals, & hip musculature, which can improve running mechanics and reduce lower extremity overuse injury reincidence.