We need to talk about “shin splints”. We hear this term thrown around very loosely, and we want to clear the air about what it really means - and where the confusion lies. So today, the South Burnett Podiatry team are talking about why your shin splints diagnosis may be wrong - or at least, not what you think it means.
The confusion around shin splints
The confusion around shin splints starts because health professionals (as well as the general public) often refer to not one but three (at least) different conditions as “shin splints”. This isn’t incorrect, as there’s no one clear, unified definition of shin splints that is agreed upon by medical professionals.
The confusion comes when you hear the term shin splints, look it up on Google when you get home, and what you find on Google isn’t actually the mechanism of injury behind your pain. Not only is this confusing, but it can result in you making decisions that aren’t actually in the best interest of your recovery, without you knowing it.
This is why it’s so important to not only know what is wrong, but understand what has caused it, and why it is causing the symptoms that it is.
So, what conditions are referred to as shin splints?
Medial tibial stress syndrome
This is probably the most common interpretation - when we tell you that you have shin splints, this is usually what we mean. As per the name, this shin pain is caused by increased stress on the inside (medial border) of your tibia (shin bone).
This stress is caused by muscles that attach to this area on the bone, resulting in either damage to the muscle where it attaches to the bone, or to the lining of the bone that it pulls on. It is often related to a flatter (pronated) foot posture, which can strain and overuse muscles, like the tibialis posterior.
Anterior compartment syndrome
Your lower leg is made up of four ‘compartments’. Each compartment houses specific muscles, tissues, nerves and arteries. Each compartment has a lining that prevents the compartment from over-expanding.
In anterior compartment syndrome, when a muscle at the front of your shins called the tibialis anterior swells from being overused, it places a tight (and often painful) feeling at the front of the shins. This pressure and discomfort can settle with rest, and recur when you start exercising again.
Tibial stress fracture
While we hope that your practitioner will let you know when you’ve sustained a stress fracture, we have seen this referred to as shin splints, too. Tibial stress fractures occur when repeated strain on the shin bone results in a fracture starting to form
Unlike traditional fractures, stress fractures start as a small hairline crack in the bone, and worsen over time if they are not treated (and the stress on the bone continues). As stress fractures can take many weeks to show up on x-rays, this may explain why it is diagnosed as a broader ‘shin splints’ instead.
Unfortunately, treating a stress fracture has different key focuses than treating medial tibial stress syndrome and anterior compartment syndrome, emphasising the importance of understanding your diagnosis!
How do we help shin splints?
The first way we help is to understand what your diagnosis is and what has caused it to occur. From here, we will create a treatment plan based on your symptoms, condition and your lifestyle. When we say lifestyle, we mean that while some people are able to incorporate more rest into their day at their office, others have no choice but to stand or walk on their feet. This means our approach to treatment will differ to match what is likely to give you the best results given your commitments.
We may use:
- Shockwave treatment
- Custom orthotics
- Dry needling
- Splints, braces or boots
- A stretching and strengthening programme
- Footwear adjustment to more stabilising and supportive shoes
- Teaching you strapping methods to use during certain sports
- Gait retraining following a running assessment