Shin Splints

Keywords; shin splints.



This lower leg condition can be so extremely painful that you may have to use crutches if you want to go for a walk around the town; but for the majority it's just a real nuisance.

The pain is experienced in the inner, lower leg by serious and casual athletes alike but also by dancers, and even those who simply love to enjoy a bit of regular aerobic sport. It can be so severe that the sufferer can barely walk due to the agony.

Whilst, yes, it's true, it's a condition limited to the person who loves some form of sport, it's good to recognise that active people have far less of the more serious diseases that haunt those who participate in no or little exercise at all.

Less heart disease, stroke, hypertension, arthritis and especially less chance of having to stab yourself several times a day; diabetes isn't fun. All these conditions face the couch potato and they're not just unpleasant but life threatening.


Shin Splints

Mostly it’s a self limiting condition, meaning it'll get better of its own accord with no treatment. Exercise hurts, so you stop exercising and the pain goes away. But that’s not an option for the serious athlete and those hooked on aerobics. Then the condition may become chronic and very debilitating.

Several muscles attach to the inner shin bone, or tibia. The one usually affected is the soleus, one of the two big calf muscles.


and the semi tendinosis, one of the hamstring muscles.



"In thigh-high yellow leather boots

Plump Saphonisba strides.

Too bad that, just to hide her calves,

Two calves have lost their hides."

- X. J. Kennedy

Chiropractic Help

Enter the chiropractor. We like to treat the causes, not just the symptoms. So what are the causes? Frankly there are many. Hyper-pronation of the ankle is one of the main causes. Flat feet.

You can surely see the difference:


A bit of anatomy

However there are many other causes from tight calf muscles, the soleus and gastrocnemius, insufficient warm up techniques and a sudden increase in training. In practice, as chiropractors we often find many other associated conditions that could be the underlying cause of your shin splints. These could be fixations in the foot or a subluxated sacroiliac joint; there is no substitute for a careful and thorough examination.

Muscles move bones, and connect to the bone via a tendon, albeit a very short tendon in the case of the Soleus, but a very long tendon of the Semitendinosus.

A ligament by the way connects bone to bone, whereas a muscle to bone connection is via a tendon.

These tendons connect to the shin bone via so called sharpey fibres that root deep into the peri osteum, around the bone, the connective tissue bone sheath, hooking the tendon firmly to the bone.

In a so called tendonitis, these fibres rip out of the bone causing pain when the muscle contracts. Often though, there is less discomfort during exercise if the athlete follows a proper warm up procedure; but, after the workout, the stabs return with a vengeance.

The pain of shin splints can be experienced anyway from just below the medial, or inner, knee, and right down to the medial malleolus of the ankle. It may be a very sharp and debilitating, often brought on after a long layoff without proper preparation for the new season.


Here's an anecdote from the coalface. A young woman in her early thirties, very active but not an athlete, consulted me recently with severe inner shinbone pain. She loved to jog, do a bit of aerobics but was hardly a fitness freak; just active.

Two and a half years ago she started getting shin splints. Within a few months it was so painful that she literally could not walk more than a hundred metres. To go op stap as young people call it in Holland, a Friday night on the town, she literally had to use crutches.

She had tried everything she told me.

It proved to be an interesting case. She had no flat feet, which is often the case, but she did have a short leg, and a fixation in the opposite sacro-iliac joint. There is pretty standard, and dealing with those alone might have fixed her problem. But what was interesting was the she had marked fixations in the medial cuneiform bone in the foot and a fibula head fixation.

The expected medial shinbone pain periosteal pain at the insertion of the soleus muscle, but also following the semitendinosus muscle way up into the thigh were present.

She is well pleased. In just three weeks the pain has halved, and last weekend she went for a stroll around the town for the first time in two years.


Treatment @ Chiropractic Help

  1. She had already stopped exercising, but in your case, for your shin splints you will have to temporarily stop, or drastically reduce your exercise program.
  2. Take a polystyrene cup, will it with water and place it in the deep freeze. Take it to the bath, and give the shin an ice massage, alternating with the hot bath. Peel away the polystyrene as needed. Rule of thumb: Alternating ice/heat after exercise, plain heat before training.
  1. The soleus beds into the Achilles tendon. Start a daily set of stretches. ANKLE exercises.
  2. After your ice/heat treatment, use a little cream and run your thumb down your shin, feeling for bumps and painful spots. Press. Don't be shy, because if it doesn't get better with your own ministrations, then you can be sure that your chiropractor is going to press pretty damn hard. In Holland we say, 'gentle healers make stinking wounds.' Whilst I don't necessarily go along with that, the treatment of tendon and muscle conditions is usually painful.
  3. Pain is ironically your friend. It's not good sense to take pain killers and anti-inflammatories and go out an train. Listen to your friend Mr Pain. He's trying to tell you something.
  4. Take this little 'wet test' to see if you have flat feet:


Ankle joint sprain

Underlying all your pain is often an old injury; perhaps an old sprain. Ankle sprain treatment is in effect prevention of these problems that develop later.  


  1. You may be able to find some inners to help with foot pronation, but you may have to get a custom set made. The're expensive; try the drug store first!
  2. Shin splints often comes on after training on a hard underfoot. Concrete, for example. Start your training on a level grass field, like a football pitch.
  3. How are your shoes? Worn out? Giving enough support for your peculiar feet?!! A good set of orthotics helps with shin splints, in conjuction with treatment. Even on their own they might help.


Buying running shoes

Buying the right shoe for your foot is imperative. Don't do it in a rush because the wrong shoe can certainly result in foot and ankle pain, shin splints and even knee and hip pain.


When to consult your chiropractor?

This is always a difficult question to answer. I don't believe you have to rush off to your doctor for every little snivel, or your chiropractor whenever you have a pain. Try some common sense home care for a few weeks.



But do understand that if you allow it to become chronic, you will have to go onto a rehabilitation program, and an occasional regular treatment with your chiropractor for some months, all of which starts to cost. This applies just as much to shin splints as it does to neck pain.

When you know, honestly deep down, that this is not getting better then do not delay any longer.

Tip: Make sure you find a sports oriented chiropractor for this condition. Your regular DC who only adjusts the spine will help, but his tools may prove limited. Call the chiropractic association and ask for a chiropractor with fics qualification.


BREASTBONE PAIN ... a nasty kindred spirit

Bone-bone, bone-ligament and bone-tendon conditions can all be very disheartening. Chiropractic works with all three.


Links


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Interesting challenges of the day

1. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks she was 75 percent improved; no longer vomiting or falling. She's not enjoying the Brandt Daroff home exercises.

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.