SHIN SPLINTS

SHIN SPLINTS can be extremely painful, so much so that you may have to use crutches if you want to go for a walk around town. Mostly it's just a real nuisance.

The pain is experienced in the inner (medial) shin by serious and casual athletes alike but also 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 pain.

Mostly it’s a ‘self-limiting’ condition. 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. Thus the condition may becomes chronic and debilitating.

Several muscles attach to the inner shin-bone (tibia). Those usually affected are the Soleus (a calf muscle) ...

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 management

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 sacro-iliac 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’ 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 pain during exercise (if the athlete follows a proper warm-up procedure), but after the workout the pain returns with a vengeance.

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

FROM THE COAL FACE

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, 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 Semi-tendinosus 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 'op stap' for the first time in two years.

Treatment

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.

   

3. The soleus beds into the Achilles tendon. Start a daily set of stretches. ANKLE exercises.

4. 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.

5. 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.

6. Take this little 'wet test' to see if you have flat feet:

   

   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!

7. 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.

8. 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. On their own they might help.

When to consult your chiropractor?

But do understand that if you allow it to become chronic, you will have to go onto a rehab program, and an occasional regular treatment with 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 a FICS qualification. FICS ONLINE.

BREASTBONE PAIN ... a nasty kindred spirit