What is a shin splint?
Shin splint is a frequent lower extremity overuse condition. It is most common in runners and other athletes who engage in heavy weight-bearing exercises, such as jumpers. Exercise-induced pain across the front tibia is the primary symptom.
A Shin splint is a buildup of unrepaired microdamage in the cortical bone of the distal tibia. The pain is caused by periosteum irritation caused by excessive tibialis posterior or soleus traction.
CAUSES ARE:
The primary cause is repetitive weight-bearing activities along with pronation, which occurs when the foot slides inward too far. This puts a twisting tension on the shin muscles, resulting in pain, swelling, and tears. In severe cases, the muscle may pull away from the tibia, resulting in stress fractures.
CLINICAL PRESENTATION:
- Increasing discomfort during exercise along the medial tibial border in the middle and lower thirds of the leg.
- Pain might last for hours or days even after you stop doing the causative activity.
- More than 5 cm of intense tenderness along the affected medial tibial border
- Pes planus.
- Tight Achilles tendon.
DIFFERENTIAL DIAGNOSIS
What else you can suspect if you have shin pain?
- Tibial stress fracture.
- Fibular stress fracture.
- Acute compartment syndrome.
- Chronic exertional compartment syndrome.
- Congenital anomaly.
- Tumor.
MANAGEMENT:
- MTSS is managed conservatively, with physiotherapy and activity adjustment, with less repeated, load-bearing activities.
- Analgesia is frequently provided by NSAIDs and acetaminophen.
- Analgesic gels can be used for 20 minutes following the exercise.
- Other treatments may include iontophoresis, phonophoresis, and ice massage.
Physiotherapy Management
Pain management treatment: This includes treatments such as periosteal pecking or dry needling, soft tissue mobilization, Tissue flossing and taping, as well as modalities such as ultrasound therapy, interferential therapy, and extracorporeal shockwave therapy.
Taping includes: Taping the foot arch or the affected leg muscles.
Stretching and strengthening exercises: This will aid in the improvement of calf musculature endurance and gait overpronation. Additionally, physiotherapists target hip and core musculature strength to improve running mechanics and prevent additional overuse issues.
- The physiotherapist uses a progressive loading exposure program to prepare the leg muscles and other structures to endure the stress of sports or ordinary running.
- eccentric calf strengthening program.
- Patients may benefit from strengthening their core & hip muscles as well. Developing core stability through the development of strong abdominal, gluteal, and hip muscles can enhance running mechanics and prevent lower-extremity overuse problems.
Proprioceptive & balance training: This will help to improve the leg muscles’ efficiency and reaction time to diverse running surfaces. which includes:
- Squats, reaching exercises, and heel lifts are examples of single-leg exercises.
- For Jumping athletes, take-off and landing techniques have been modified.
- Enhanced leg and foot control during walking and running
Physiotherapy treatment also includes optimal functional gait and body biomechanics. a physiotherapist will recommend you:
- shock-absorbing & pronation control insoles,
- Avoid over stress
