Been given a diagnosis of shin splints, compartment syndrome, medial tibial stress syndrome or tibial stress fracture? What now?
Usually a combination of training errors and biomechanical abnormalities are present. Pain develops from repetitive loading during activities such as running and jumping, the repetitive stress doesn’t allow the area to heal. Initially pain is provoked with the start of exercise and hangs around after exercise, eventually the pain can affect everyday activities.
What’s The Difference?
Medial tibial stress fracture – an incomplete crack in the bone. Pain is felt whilst resting, particularly in the morning with a pinpoint spot on your bone that hurts to touch.
Medial tibial stress syndrome – repetitive-stress injury of the tibia and surrounding muscles. Diffuse pain and tenderness is felt over a vague area of more than 5cm
Chronic exertional compartment syndrome- true compartment syndrome restricts the blood flow to the muscles caused from intracompartmental pressure or popliteal artery entrapment. This can cause swelling, unusual nerve sensations, cramping, burning, pressure-like calf pain during exercise. No pain will be felt when resting.
Conditions affecting circulation such as diabetes
Increased body mass index
Excessive pronated foot posture (flat feet)
Poor hip control during running and jumping
What Can I Do About It?
Treatment will depend on the type of shin splints you have, severity and duration of your symptoms.
‘Relative’ rest to offload the area. Modify your running to offload from hard and uneven surfaces, reduce the duration or frequency to allow healing.
Have your shoes assessed for support (or lack of) and shock absorption capacity
Research indicates a graded loading program has superior long term benefits, the focus of strengthening will vary between individuals. Some may need abdominal, gluteal, and hip muscle strengthening to improve running mechanics and prevent lower-extremity overuse, others may need calf muscle strengthening and foot control exercises.
Correction of functional movements, gait, and biomechanics may be needed to reduce overload factors
Treatments such as shockwave therapy, taping, acupuncture, massage, orthotics and joint mobilisation can assist with symptoms and help you get back to everyday activities without pain.
Gradually return to sport with pain-free activity