Do You Get Pain In Your Shin When You Run?
As runners start ramping up the k’s over winter in preparation for the various running events coming up I have seen an influx of people coming in with shin pain. Commonly referred to as shin splints, shin pain is an umbrella term used to describe the different causes of the pain around the lower shin area. The most common form of shin pain is medial tibial stress syndrome (MTSS) and occurs along the lower medial aspect of the tibia above the ankle. Research suggests MTSS has an incidence of up to 17% in runners.
Traction from specific muscles inserting into the tibia are thought to be the main culprits leading to inflammation at the tendon-bone insertion and periostitis (inflammation of the outer layer of the bone). The 3 main muscles (tibialis posterior, soleus and flexor hallucis longus) are all responsible for controlling foot function so there is a strong interaction between MTSS and the way the foot functions.
Typically you will start to feel a dull ache in the lower shin area that will usually worsen often becoming very sharp with exercise, in particular running. The shin will become sore to touch and will eventually force a reduction in exercise. The cause is usually poor running biomechanics, increasing training load or duration too quickly or increased body mass. There are other factors such as bone density, shoewear and training surfaces that also need to be assessed.
When treating MTSS the first priority is to decrease the training load to allow the injured structures time to heal. At Melbourne Podiatry Clinic we use techniques such as soft tissue massage, dry needling, cold spray/stretch and joint mobilisation to enhance tissue repair and reduce the symptoms. It is very important when treating MTSS to understand the individual cause and as this is strongly linked to foot and leg mechanics, a running gait assessment is crucial. From analysis of the running gait we can determine if a change of shoes or orthotics will be required to provide better support and reduce the load on the injured tendons and at the insertion point along the tibia.
Andrew Maitland is a sports podiatrist at the Melbourne Podiatry Clinic. Having worked closely with many elite and amateur runners over the years he has helped many people in the prevention and treatment of running injuries.