Overview

What are Shin Splints?

The shin (Tibia) is the bone located on the front of the lower leg below the knee. Pain over this bone or pain involving the muscles on either side of this bone are referred to as Medial Tibial Stress Syndrome (MTSS), or more commonly known as “Shin Splints”.

The pain experienced is a result of repetitive stress on the inner border of your tibia (shin bone), resulting in inflammation and pain. Shin Splints can arise due to changes in training factors (volume, type, intensity) and are often associated with lower limb muscular weakness, unfavourable biomechanics and poor footwear.

Types of Shin Splints

There are two primary types of Shin splints can – they depend on the source and location of your pain.

Anterior Shin Splints

If your shin pain is more localised to the front or ‘anterior’ aspect of your shin, then the pain is arising from the tibialis anterior muscle. This muscle lines the front part of your lower leg and is responsible for dorsiflexing the foot (bringing the foot towards you). This muscle is very active in running as you are required to clear the ground with your foot throughout the stance phase of running. If this muscle becomes tight as a result of weakness or overuse, it can increase the amount of strain applied along the anterior portion of the tibia, resulting in pain.

Posterior Shin Splints

Similarly, pain that is more localised to the inner border of your shin, is likely arising from the tibialis posterior muscle. This muscle lines the medial portion of the tibia and supports the arch of your foot when in weight bearing.

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Shin Splint Symptoms

Shin Splints present as a diffuse, vague pain along the inner or front border of the tibia. The location will depend on the type of shin splints you are experiencing.
In the early stages, Shin Splint symptoms will tend to warm up or ease as you exercise, and may return post-exercise. In more severe cases the pain will not ease and continue to worsen, or even persist with rest.

You may be able to palpate your pain on the muscles that align the shin bone, or it may feel that the pain is on the bone itself. In most cases it is a combination of both.

Shin Splint Causes

The term overload means that the tissues have been subjected to forces that exceed their current capacity. When coupled with inadequate healing opportunity then injury is more likely to occur. Various factors can contribute to tissue overload, including:

  • Rapid increases in training volume or intensity.
  • Inadequate recovery between bouts of exercise.
  • Lower limb muscle weakness.
  • Altered running/gait biomechanics.
  • Poor footwear or footwear changes.
  • Running on hard surfaces.
  • Flat feet or weak foot musculature.

Shin Splint Assessment

If you are suffering from Shin Splint-like symptoms, it is recommended that you contact PEAK to have one of our Podiatry, Physiotherapy or Chiropractic Practitioners conduct a thorough assessment and diagnosis.

As listed above, a combination of training errors and biomechanical factors play a role in the development of Shin Splints. A thorough training history, with particular focus on recent changes, is required to help guide any training modifications that may be required.

In the physical assessment, palpation of the painful area is an important diagnostic factor, particularly along the medial border of the shin. Your Practitioner will also assess your lower limb muscle strength and function, particularly around the hip, knee and ankle regions to determine whether these are contributing to your symptoms. Research indicates that muscular weakness can lead to early fatigue and contribute to poor loading patterns along the tibia.

Additionally, as running is such a popular sport and cause of Shin Splints, a thorough Running Assessment is highly recommended. Subtle technique changes and cues can change how force is transferred through the affected area, and assist with minimising pain and preventing recurrence.

Finally, a Podiatrist  can assess the suitability of your footwear based on your foot posture, foot muscle function and training modality (ie. road vs trail running). Changing the type of footwear or adding orthotics can help to offload the painful areas and aid the recovery process. Furthermore, alternating between multiple pairs of running shoes can help to maintain the shoe’s structural integrity.

It is important to rule out more sinister diagnoses which may present similarly to shin splints – the most common being a stress fracture. Stress fractures are a progression of shin splints whereby the bone begins to develop small cracks. Stress fractures tend to present with pain at rest, night pain and very specific points of tenderness. If you are experiencing these symptoms your PEAK practitioner may recommend a bone scan or MRI to exclude this diagnosis.

Shin Splint Treatment

Orthotics for Shin Splints

If any biomechanical abnormalities are identified in the physical assessment, your PEAK practitioner may recommend the use of orthotics. Orthotics can provide support to specific areas of the foot, thus offloading the muscles while they begin to heal, as well as provide cushioning where required.

Massage for Shin Splints

Soft tissue techniques such as Massage, Trigger Point Therapy or Active Release Technique (ART) can also be effective for relieving Shin Splint pain. These techniques provide benefit by reducing muscle tension of your shin muscles which relieves the amount of pull or strain they exert on the bone. Furthermore, blood flow to the area is increased, allowing the muscles to relax and healing to occur. The type of soft tissue mobilisation used will depend on the location and severity of your symptoms.

Dry Needling for Shin Splints

Dry Needling is another treatment technique that can be beneficial for Shin Splints. Dry Needling specific locations along the affected muscles helps to relieve muscle tension via a twitch response, and promote blood flow and nutrient circulation to these regions. It is normal to experience a short-term increase in discomfort following a Dry Needling treatment.

Shin Splint Exercises

Exercise therapy is a key component of Shin Splints rehabilitation and prevention. As research shows that lower limb muscle weakness and dysfunction contributes to the development of Shin Splints, a comprehensive exercise program targeting these is key. Your practitioner will design an exercise program which addresses the key impairments identified in the physical assessment. Stronger lower limb muscles will minimise the amount of force which travels through the joints/bones of the leg. Similarly, by improving your function and biomechanics, the load may be distributed throughout the leg in a more efficient way, thus offloading the painful area.

How To Prevent Shin Splints

Shin Splints are highly susceptible to re-injury, especially if training errors, strength deficiencies and poor technique are not corrected. As such, the key to a successful Shin Splint rehabilitation is to adopt a preventative approach. Important principles of preventing Shin Splints from recurring include:

Managing training factors by avoiding sudden and dramatic changes in volume, intensity, duration or surfaces, and allowing sufficient rest between exercise.
Maintaining muscle strength will reduce the likelihood of running into muscle fatigue and overload throughout running. Having stronger muscles will minimise how much stress and strain your leg joints and bones are subjected too.

Having the correct footwear to suit your specific foot posture, gait pattern and training modality.
Having a run assessment to determine if your gait style may predispose you to this injury.

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FAQs Frequently Asked Questions

Ice and ‘relative rest’. Avoiding activities which cause high pain levels and allowing adequate recovery between bouts of activity is important to allow the healing process to occur. Factors such as sleep, stress, hydration and nutrition are all fundamental in speeding up recovery times, as well as manual therapies including Dry Needling, Mobilisations, and Remedial Massage.

Whether or not you can run with shin splints is dependent on the severity of your condition. In extremely irritable cases, a short period of complete rest may be recommended. However, in most cases the idea of ‘relative rest’ is applied, whereby your running/training volume is reduced (not ceased) to a more tolerable level. This allows the irritation around your shins to settle, while also increasing their tolerance to the relevant activity. Your PEAK Practitioner will guide you on what is and is not appropriate for your specific condition.

Dependent on severity and irritability of your symptoms. If symptoms do not warm up during exercise and are present at rest, it may be beneficial to trial a 1-2 week period of complete rest to allow the inflammation to settle. It is important to know however, that resting will not increase the strength of the surrounding muscles, and therefore may not be addressing the underlying cause of your symptoms. Your PEAK Practitioner will guide you on what is and is not appropriate for your specific condition.

Yes. As long as walking does not increase your pain levels, then it is good to maintain at least some level of activity throughout the muscles and bones around your shins. Complete inactivity can result in further reductions in strength and function, further contributing to the condition. Your PEAK Practitioner will guide you on what is and is not appropriate for your specific condition.

Our locations

Hawthorne

PEAK Hawthorne opened in 2012 and was extended and renovated in 2020. You see the same team whether we see you at Hawthorne or one of our other clinics.  Hawthorne offers private treatment rooms and a spacious exercise area incorporating the latest equipment and technology, unrestricted single level access and off-street parking. We also provide HICAPS for real-time private health claiming.

Our locations

New Farm

PEAK New Farm opened in August 2019. You see the same team whether we see you at New Farm or one of our other clinics. New Farm offers private treatment rooms and a spacious exercise area incorporating the latest equipment and technology, unrestricted single level access and off-street parking. We also provide HICAPS for real-time private health claiming.

Hawthorne

Address
5/171 Riding Road,
Hawthorne, QLD, 4171
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Opening Hours -
6 days per week
  • Monday - Friday: 7:00 am - 8:00 pm
  • Saturday: 7:00 am - 1:00 pm

To make a booking outside of business hours, please use our form by clicking here.

New Farm

Address
1/15 Lamington Street,
New Farm, QLD, 4005
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Opening Hours -
6 days per week
  • Monday - Thursday: 2:00 pm - 8:00 pm
  • Friday - Saturday: 7:00 am - 1:00 pm

To make a booking outside of business hours, please use our form by clicking here.