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Posted on 02-20-2013

Good Morning!

How many of you have ever complained of shin splints?  Some of you are probably athletes, while others are senior patients who simply enjoy walking around their neighborhood to stay healthy.

Shin splints are very common.  These patients complain of a dull, aching pain felt either along the medial side of the tibia or the anterior side of the tibia.  Once the pain starts, any activity will aggravate it.  In some cases, complaints of pain along the anterior side of the tibia can be a medical emergency due to lack of blood flow leading to neurosis and gangrene of muscle in the front compartment of the leg.

How are shin splints caused?

Medial shin splints:  The tibialis posterior (front of the lower leg to the outside) muscle plantarflexes and inverts the foot (anti-pronator) due to its furthest attachment on the inner aspect of the foot.  During over-pronation the tendon of the tibialis posterior is stretched and pulled upon excessively, thereby attacking the weakest area.  The small pain fibers of the periosteum are torn away causing pain and chronic inflammation. 

Anterior shin splints:  The tibialis anterior muscle pulls your foot back and inverts the foot, acting as an anti-pronator due to its insertion on the medial aspect of the foot.  During over-pronation the tibialis anterior muscle fibers must fire constantly to oppose the over-pronation, thus causing swelling of the tibialis anterior compartment.  With the anterior compartment being tightly constricted, the swollen tibialis anterior can cause an obstruction of blood flow, which can cause severe pain due to lack of oxygen. This can be very serious and may require emergency surgery. 

Depending on the severity of the injury, medial and anterior shin splints can be treated with the same care.  Treatments may include:

  • Standard acute care—Icing the shin to reduce pain and swelling.  Do it for 20-30 minutes every three to four hours for two-three days, or until pain is gone.  
  • Footmaxx Orthotics—You  would benefit from an orthotic device designed in our office that corrects over-pronation and stops the foot from falling too far medially and facilitates proper foot function and timing, reducing stress on the tibialis anterior.
  • Rest and Reduce Activity—Have your foot adjusted and allow the shin splints to heal before they become more severe or cause more issues.
  • Have a blessed day! 

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