While a number of injuries of the lower leg get labeled as shin splints, the classic version is when the fascia or connective tissue surrounding the Posterior Tibialis muscle of the lower leg tears away from the inside of the Tibia along the sharp edge of the bone. Excessive impact in this area can evolve into a fracture depending your body mechanics and the level of repetitive stress those mechanics produce.
Another version of shin pain is an Anterior Shin Splint. In this case the Anterior Tibialis is bearing the brunt of repetitive stress and the pain site is on the lower front of the leg where the tendon of the Anterior Tibialis descends towards the top of the foot. This is usually caused by excessive heel striking, and there will be more risk when running on downhill hard surfaces.
Causes and Considerations
It is often the case that runners and participants in youth athletics will get shin splints early in the season after a lay off. This is a classic case of “too much to soon” and pain will generally fade with a short break. However if your shin splints tend to stay around read on.
I find that in working with runners that suffer from chronic shin splints there is usually too much tightness or holding in the muscles of the leg. It is often accompanied by a muscle imbalance in the hip on the involved side (if it is one sided), and because that creates instability, the leg compensates by trying to stabilize from below. The leg muscles become dense, thick and non-resiliant. Forces don’t transmit well through this dense medium and the muscles get jammed with each step. So one thing to look for is asymmetry in the hips and leg/foot mechanics, side to side.
When the shin splints are in both legs and chronic there are basically two things to look for. The runner may be driving down through their legs to get more power off the ground. Again this would be a compensation for not getting the power from the core. This involves too much impact, usually with a heel strike that shocks the tissue of the lower leg. The second is overuse such as pushing excessively off the toe and or landing on the ball of the foot without allowing the heel to contact the ground. This adds tremendous forces to the calves and can be the *source of a number of lower leg problems.
Healing Shin Splints
The current medical practice would be ice, elevation, and rest (layoff), allowing the symptoms to ease. However this doesn’t address the faulty mechanics that started the pain in the first place. To get at this it is important to realize that you don’t have to use the legs to run, except minimally. And if you are able to learn this you can often heal the shin splints while maintaining your running base.
Focusing on smooth gait, soft and dangling feet during the swing phase, shortening up the stride and developing a mid-foot strike (heel makes firm contact, but not striking out front), rolling off the balls of the feet without a push, and driving forward with the upper thighs and hips, will all help to ease the stress to the calves, ankles and feet.
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*Injuries to the lower leg that can be helped with form focuses: calf strains, calf pain, tight calves, Achilles Tendonitis, Posterior Tibialis Tendonitis, Posterior Tibialis Tenosynovitis, Chronic Compartment Syndrome of the Anterior Compartment, lateral leg pain, Peroneal Tendonitis. There are specific focuses that can be used to help heal specific injuries. Contact Douglas for more information.