Anterior Shin Splint

ANTERIOR SHIN SPLINT

 

 

INTRODUCTION:

Shin splints is the general name given to pain at the front of the lower leg. Shin splints is not a diagnosis in itself but a description of symptoms of which there could be a number of causes. The most common cause is inflammation of the periostium of the tibia (sheath surrounding the bone). Traction forces occur from the muscles of the lower leg on the periostium causing shin pain and inflammation. It is often caused by running or jumping, and may be very slow to heal. Formal medical terms include medial tibial syndrome, medial tibial stress syndrome and stress-related anterior lower leg pain.

CAUSES:

  •  Overused muscle

One cause is overused muscle either an acute injury or DOMS(delayed-onset muscle soreness). The muscle pain is caused by any activity that involves running, jumping, also sometimes even walking, swimming or playing basketball. An individual not accustomed to running may experience pain in the shin muscles the next day even after a single, short bout of intensive running. the purpose of muscle of anterior shin(tibialis anterior) is to dorsiflex the foot (bend the foot upwards at the ankle). Other muscles here include the extensor digitorum longus muscle and the extensor hallucis longus, which move the toes, 2-5 and the big toe respectively, upwards. It may not be obvious why a muscle which raises the toe can be stressed or injured by running, given that it is not responsible for propulsion. The reason is that unskilled runners overstride, and land heavily on the heel with each footstrike. When this happens, the forefoot rapidly slaps down to the ground. Effectively, the foot, which is dorsiflexed prior to making contact with the ground, is forcefully plantarflexed. This forceful plantar flexion of the foot causes a corresponding rapid stretch in the attached muscles. A reflex in the muscles responds, causing a powerful contraction. It is this eccentric contraction which leads to muscle soreness and possible injury to the muscle, tendon or connective tissue.

In a similar way, improper probation of the foot during the footstrike can also cause pain in the muscles which oppose pronation, on the inside or outside of the shin.

  •  Inflammation of connective tissue

Shin pain may also be the result of inflammation of connective tissue such as periosteum (periostitis). The pain may be caused by a stress fracture in the bone or some other problem like osteosarcoma. Pain in the lower leg may also be referred from a distant area of the body, such as pressure on the sciatic nerve sciatica which lies in the posterior thigh.

  • Chronic Compartment Syndrome

A problem which can mimic anterior shin splints is chronic compartment syndrome(CCS). This is a serious problem which can lead to significant loss of function in the lower leg. CCS occurs when swelling within the indistensible anterior compartment of the leg reduces blood flow. This relative lack of blood,ischaemia , can cause more swelling and generate a positive feedback loop. In severe cases the result can be acute compartment syndrome (ACS) which requires emergency surgery to prevent ischemic muscle necrosis, muscle death due to lack of blood.

SYMPTOMS:

  • Tenderness over the inside of the shin.
  • Lower leg pain which goes after a period of rest but comes back when running starts again.
  • Sometimes some swelling.
  • Lumps and bumps may be felt when feeling the inside of the shin bone.
  • Pain when the toes or foot are bent downwards.
  • Redness over the inside of the shin.
  • Shin Splints Treatment
  • Treatment for shin splints is a simple as reducing pain and inflammation, identifying training and biomechancial problems which may have helped cause the injury initially, restoring muscles to their original condition and gradually returning to training.

DIAGNOSIS:

  • CCS may be the problem if pain worsens steadily during exercise rather than improving as the ligaments and muscles warm. Tingling in the foot is a particular red flag; it indicates compression of the nerve.
  • If a bone problem is suspected to be causing inflammation of connective tissue, a bone scan can be useful in confirming the diagnosis.
  • Magnetic resonance imaging has been proposed as a diagnostic technique.

TREATMENT:

PHYSIOLINE’S SPECIALIZED PHYSIOTHERAPY HAS VITAL ROLE TO PLAY

At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:

  • Pain relief with electrotherapy
  • Reduce swelling
  • Strengthening of muscle
  • Flexibility training
  • Regain full range of motion
  • Taping of foot for support
  • Prescription of orthosis

 

  • Shock absorbing insoles

Shock absorbing insoles can help reduce the shock and impact transmitted through the foot to the lower leg, particularly when running on hard surfaces for long periods of time.)

  • Orthotic insoles

Orthotic insoles are firm insoles designed to correct biomechanical dysfunction such as over pronation. They will usually have strong arch support

  • Shin and calf supports

Shin and calf supports can provide compression and support for the lower leg and retain the bodies natural heat.

  • Slant boards

A slant board is a simple but effectrive device which helps with accurate and progressive stretching of the calf muscles. Buy slant board

  • Sports Strapping Tape

Zinc oxide sports tape is excellent for applying a simple taping technique.

Visit Physioline for the Consultation and treatment