Treatment for Shin Splints
by Eric Winder, D.C.
Relief for shin splint pain is almost always possible, but some cases are easy, while others require professional help. This ailment of runners (and some walkers) might simply be rectified with a change of shoes or learning how to stretch properly. However, other cases can be stubborn, continuing to hurt months after ending the culprit activity. In this article, we will look at why the pain can persist and how it can be relieved.
Shin splints result in microtears or inflammation in certain lower leg muscles and along the bone where those muscles attach. The pain can continue for many hours after running or walking. This frequently causes pain when a person first starts to move in the morning, as their muscles have stiffened overnight.
This common injury is caused by excessive force on both the lower leg muscles and their attachments. Many people who have shin splints must stop running completely while healing which can take anywhere from several weeks to months without intervention.
The cause of shin splints is often simple and can be easily fixed in many cases. For instance, a runner might realize that she jumped too quickly into a strenuous running program on hard pavement. After taking two weeks off, buying shoes that are adequate for hard surface running and following a more incremental training schedule, she will likely be able to run pain-free and never look back.
Another runner might be advised that his shoes show a foot pronation wear pattern and then find that using shoe inserts or finding another shoe that corrects the pronation will end the pain. These above examples illustrate the three simplest causes of shin splints:
Doing too much activity, too soon
Running or walking extensively on hard surfaces with inadequate shoes
Pronation, or collapsing of the ankle and foot arch
However, most patients of the patients I see have already tried correcting the above problems. They improved their shoes, altered the pace of their training, taken breaks if needed, and begun to stretch in addition to their running or walking routine—but they still have pain. In these cases, we need to look at other problems that cause excess strain of the leg muscles.
For these people, I find there is generally some kind of imbalance in the muscles of their lower back, hips or thighs. These, in turn, cause a loss of perfect control of their joint alignment and stability while they are in motion which their leg muscles try to compensate for. This overstresses the leg muscles and results in painful shin splints. Let’s examine two cases that further illustrate this problem.
A patient, whom I will refer to as Tammy, had been a long-distance runner in high school, but experienced shin splint problems when she tried to resume running in her 30s. She thought that the pain would resolve once her body acclimated to the running, but instead, it continued to worsen.
She took weeks off and tried to ease back into running at a slower pace, but still the pain persisted. She changed shoes, wore arch supports and became a diligent stretcher—all to no avail. She was upset and frustrated to see how something that came so easily to her in her teenage years could have become so difficult now.
As it turned out, Tammy had tight hip flexor muscles and weak, underdeveloped glutes. This was not from a lack of stretching and exercise, but rather, the result of restrictions in her lower back and hip areas in the connective tissue, called fascia. This tissue provides the position sense that allows for proper muscle balance.
A series of treatments to release the restrictions, combined with low-level laser therapy to reduce inflammation and promote healing in the leg muscles, corrected the muscle imbalance. This allowed Tammy to resume running completely pain-free in four weeks’ time.
A second patient, whom I will refer to as Michael, was a high school student whose track and field career was at risk due to intense shin splint pain. With the help of his team’s athletic trainer, he tried both the application of ice and stretching, and he even underwent more intense treatment with a physical therapist, but nothing could resolve the pain.
A teammate referred him to our office, and on examination, it was clear the problem did not actually start with his legs. There was a serious imbalance between Michael’s overly tight quadriceps in the front of his thighs and underactive hamstrings in the backs of his thighs. However, the source of his problem was unusual. The restricted fascia that triggered his imbalanced leg muscles was actually located in his neck, caused by mild whiplash in a car accident earlier that year.
Neck posture can affect posture in the rest of the body, although many people are not aware of this fact. When we treated and released the restrictions in his neck, Michael’s leg muscles balanced out and became toned. As a result, this eliminated lower leg stress that had originally caused the shin splints.
Low-level laser was also used in his therapy to reduce inflammation, and his pain disappeared over the course of the next six weeks. Treating the base cause of the problem allowed this healing to occur even though Michael continued to run (and frequently win) in competitive meets during the entire course of treatment.
For those suffering from shin splints, it is important to first consider the obvious solutions. Proper shoes or inserts for ankle support if necessary and slowing down the pace of training are all possible solutions. But if those simple fixes are not enough, consult an expert in posture and muscular function who can also address problems with fascia restrictions. Fascia is the source of position sense in the body which makes muscular balance possible.
Eric Winder, D.C., uses gentle manual therapy and rehab techniques, without forceful manipulation, to help patients with a wide range of pain and injury problems. For more information, call 941-957-8390 or visit Gentlebay.com. Dr. Winder’s offices are located in Sarasota and Osprey.
