Physio Penrith Shin Splints Treatment
Treatment of Shin Splints at Sydney Muscle & Joint Physio Penrith
What are shin splints?
Shin splints, also known as medial tibial stress syndrome is one of the most frequently managed overuse injuries that present to sports medicine and physiotherapy practices. Other common names include medial tibial stress syndrome, tibial stress syndrome, medial tibial syndrome, shin splints syndrome, shin splint, shin splints, shin soreness and posterior tibial syndrome. Pathogenesis theories include traction-induce periostitis, a crural fasciitis or a local tibial bone overload injury.
Traction-induced periostitis is thought to be due to repeated contractions of the (deep) ankle plantar flexor muscles pulling on the tibial periosteum (outer lining of the shin bone). Many authors have looked at tibialis posterior, soleus, flexor digitorum longus, flexor hallucis longus and deep crural fascia as being responsible for this pulling on the periosteum.
Local tibial bone overload theory, a pathogenic process similar to stress fractures, has been frequently cited. Bone overload refers to repetitive or large strains that may exceed the microdamage threshold and the osteoclast activity may outpace osteoblast activity, the bone strength decreases and an injury occurs.
Some authors have stipulated that there is more than one type of medial tibial stress syndrome. Detmer distinguished four types of medial tibial stress syndrome:
1. stress fracture (type 1a)
2. stress microfracture/diffuse stress reaction in the tibia (type 1b)
3. chronic periostalgia (type 2)
4. chronic exertional compartment syndrome of the deep or superficial compartment
What are the symptoms of shin splints?
Presenting symptoms of shin splints include pain along the posteromedial (inside) border of the tibia that occurs due to exercise, in addition, the pain has to be spread over a minimum of 5 centimetres when the posteromedial tibial border is palpated. It is extremely important to rule out other diagnoses that include tibial stress fracture and chronic exertional compartment syndrome.
Diagnosis of medial tibial stress syndrome (shin splints)
At Sydney Muscle & Joint Physio Penrith our physiotherapists use evidence-based diagnostics to help diagnose your injury. Recent research suggests that pain along the posteromedial (inside) border of the tibia that occurs due to exercise, in addition, the pain has to be spread over a minimum of 5 centimetres when the posteromedial tibial border is palpated can help to diagnose medial tibial stress syndrome (shin splints).
Further, ruling out stress fracture and compartment syndrome can help confirm the diagnosis of medial tibial stress syndrome. In a tibial stress fracture pain is often more focal and can be pin-pointed with one finger. Weight-bearing activities, such as jumping and running, provoke the recognisable pain tibial stress fractures, and rest leads to a reduction of pain. Focal pain on palpation and pain upon tapping may further contribute to the suspicion of tibial stress fracture.
Chronic exertional compartment syndrome usually presents as cramping, burning pain over the affected compartment. With regard to location, the pain is expected to be felt on the anterior (in case of the anterior CECS) or posterior side (in case of the posterior CECS) of the lower leg. The pain usually ceases quickly upon stopping the provoking activity, where pain in MTSS tends to linger for a couple of hours to a couple of days.
Treatment of medial tibial stress syndrome (shin splints)
No intervention has been proven to be effective for medial tibial stress syndrome. As medial tibial stress syndrome is most likely a bony overload injury, rehabilitation programs that focus on bone recovery seem most appropriate. One might consider several days of nonweight bearing after which weight bearing is gradually increased until full function level has been achieved.