Shin splints, medically known as medial tibial stress syndrome, are a common ailment among athletes, particularly runners, dancers, and those engaged in high-impact sports. Characterized by pain along the inner edge of the shinbone (tibia), shin splints can be debilitating and frustrating. This blog article delves into the biomechanics behind shin splints and explores various treatment options, including the innovative shockwave therapy.

Biomechanics Behind Shin Splints

Shin splints result from repetitive stress and strain on the tibia and the surrounding muscles and tissues.  Often times you hear people blame the surface or shoe gear choice for shin splints, but in reality they are a stress loading issue and is generally self-imposed.   Several biomechanical factors contribute to the development of shin splints:

Overpronation

Overpronation, or excessive inward rolling of the foot during walking or running, places undue stress on the tibia.  It is very important to understand that PRONATION IS A NORMAL MOVEMENT PATTERN to allow for shock absorption and energy loading when we walk, run and jump.  However, some of us pronate more than others due to our anatomical makeup.  Our inability to control or accept the pronation is what can lead to increased stress on the muscles and tendons attaching to the tibia, causing inflammation and pain.

Landing Position

Anyone who’s been through my running classes or trained with me on running form has heard me talk about landing position a lot, and there is good reason for it.  Most runners are now very much aware of the perils of heel striking, and this is a prime example of one potential consequence.  Heel landing causes a much more sudden and rapid pronatory force on our feet requiring extra strength and endurance in those structures responsible for controlling the pronation.  When those structures fatigue, the stress translates to the tendons and periosteal fascia of the lower leg.  Eccentric muscle contraction (when the muscles are contracting to slow down the lengthening process, aka force loading) takes much more strength and energy than concentric muscle contraction.  Improving mechanics of your landing position can drastically reduce the eccentric loading forces.

Foot Anatomy

Individuals with flat feet inherently require more ancillary arch support necessary to distribute impact forces evenly. Flat feet can exacerbate overpronation and increase the risk of developing shin splints due to the added stress on the lower leg structures.

Conversely, those with high-arched feet may experience shin splints due to inadequate shock absorption. The rigidity of high-arched feet can lead to excessive impact forces being transmitted up the leg, contributing to shin pain.

Improper Footwear

“A good craftsperson never blames their tools.”  I don’t ever like to blame the shoes, however if your body is not properly equipped than shoes that do not provide adequate cushioning or support can exacerbate improper foot mechanics, increasing the likelihood of shin splints.

Effective Treatments for Shin Splints

Managing shin splints requires a multifaceted approach that addresses the underlying biomechanical issues and alleviates pain and inflammation. Here are some effective treatments:

Rest and Activity Modification

The first step in treating shin splints is to reduce or modify activities that exacerbate the pain. Resting allows the inflamed tissues to heal and prevents further damage. Gradually reintroducing activities with proper conditioning can help prevent recurrence.

Ice Therapy

Applying ice is primarily symptom relief and will not necessarily help reduce healing or recovery time, but it can help reduce inflammation and alleviate pain. Ice therapy should be used for 15-20 minutes as needed, especially after activity.

Stretching and Strengthening Exercises

Incorporating stretching and strengthening exercises into a routine can help address biomechanical issues. Stretching the calf muscles and Achilles tendon, along with strengthening the lower leg muscles, can improve stability and reduce stress on the tibia.

Orthotics

Orthotics or shoe inserts can provide some temporary correction to correct abnormal foot mechanics. Orthotics can help distribute impact forces more evenly and reduce the strain on the tibia, alleviating shin splints.  Personally, I do not like to rely on orthotics as a long-term solution, however they can provide for short-term relief and situation management (i.e. if you are mid-season and time is of the essence).  The real solution is to strengthen your intrinsic support and not rely on external devices.

Cellwave (Shockwave) Therapy

Shockwave therapy is an innovative treatment option for shin splints that has gained popularity in recent years. This non-invasive therapy uses high-energy sound waves to stimulate healing in the affected tissues and can often heal your shin splints without totally discontinuing activity.  When your season is on the line, nothing will provide faster healing or relief.

How Shockwave Therapy Works:

Shockwave therapy involves the application of acoustic waves to the painful area, promoting increased blood flow and stimulating the body’s natural healing processes. The sound waves penetrate deep into the tissues, breaking down scar tissue and promoting the growth of new, healthy tissue.

Benefits of Shockwave Therapy

Shockwave therapy offers several benefits for individuals suffering from shin splints:

• Non-invasive and does not require anesthesia
• Minimal side effects and downtime
• Promotes faster healing and recovery
• Effective in reducing pain and inflammation

Procedure and Frequency

The procedure typically involves multiple sessions, with each session lasting approximately 15-20 minutes. Depending on the severity of the shin splints, 3-6 sessions may be recommended for optimal results.

Preventing Shin Splints

Prevention is key to avoiding the recurrence of shin splints. Here are some tips to keep in mind:

Proper Running Technique and Biomechanics

Shin splints come down to a loading shock absorption and each person’s anatomy is different.  Remember both low arch/overpronators and high arch/supinators are susceptible.  Knowing your personal biomechanics patterns and how to properly land and load forces is the key to immunity from shin splints.  To fully understand this, a detailed evaluation of your running form and movement patterns with a biomechanics expert or sport scientist may be required.

Gradual Training Progression

Avoid sudden increases in training intensity or duration. Gradually build up your activity levels to allow your body to adapt and strengthen.  This is why we see a huge influx of shin splints in the springtime when track and other sport seasons start up.

Cross-Training

Incorporate low-impact activities, such as swimming or cycling, into your routine to reduce stress on the tibia while maintaining overall fitness.  Specific exercises to strengthen some of the ancillary muscles of the foot and ankle to improve your shock absorption capabilities are key.

For questions or inquiries on how we can help alleviate your shin splints, contact [email protected] or call us to schedule a free consultation.