Are you or someone you know experiencing shin pain with activity?

Shin pain is a very common complaint this time of year, with winter sports in full flight. We see shin pain presentations in individuals who engage in activities that involve running and jumping. Not always the case, but for many of these presentations we also find that training amount (or “load”) has peaked over a small period of time.

Knowing you have shin pain is one thing, but finding out what is driving that shin pain is the key to recovery and prevention of ongoing issues. Shin pain may be caused by a number of things, including bony stress, vascular insufficiency (poor blood supply), inflammation, increased compartmental pressure, local nerve entrapment, or even referred from another part of the body such as the hip or lower back.

Medial tibial periostitis, more commonly known as “shin splints” in the public eye, is seen regularly in performance clinics like ours. It is a form of stress on the bone in which muscle traction on the shin causes inflammation at the surface of the bone/periosteum.

Symptoms:

• Wide spread pain on the inside (medial) aspect of the shin.
• A patter of pain that may be felt during the start of exercise, but may decrease during activity and ache again following exercise.

Why me?
There may be multiple facets at play here:

1. Biomechanical flaws and the way forces are transferred through the body impact exercises or other activity.
2. Footwear – type and age
3. Musular-type imbalances. For example muscle tightness, weakness or even over-activity of certain muscle groups.
4. Decreased bone density.
5. Acute change in training regimes (including changes in training intensity, frequency, duration and type)

Can I manage my shin pain?

1. It is a good idea to check in with your physio to identify the factors potentially driving your shin pain, and from there understanding the process you can take to recover and prevent the injury from progressing.
2. Undertake an initial period of relative rest by modifying training loads alongside the acute management of RICE (i.e. rest, ice, elevation and compression).
3. It is often beneficial to engage in cross-training with lower-impact exercises eg. swimming and cycling.
4. Appropriate soft tissue management, muscle strengthening and taping techniques (performed by an experienced health practitioner) may also be helpful during your shin pain recovery.

Do I need a further investigation (eg a scan)?

• Generally, the best management is to have this injury first seen by a respected health professional.
• If your physiotherapist believes a scan may be of benefit, then this can be organised from this point.