WHAT ARE SHIN SPLINTS?
“Shin splints” is an umbrella term often used to relate to pain felt below the knee along the shin bone or even in the calf. Pain is felt either along the front of the shin bone or along the back of the bone especially in the lower third. It is an inflammatory problem in nature but if left unattended it may even progress to stress fractures developing along the shin bone.
History and Causes of Shin Splints
Shin splints are common in dancing and other activities which involve repeated jumping and impact. The root cause is normally due to altered stability and movement patterns in the lower limb, foot and pelvis. Symptoms often increase over time due to repeated strain on the bone.
Common causes of shin pain are:-
- Sudden increase or change in activity. This is commonly seen with the start of a term, especially term 1 in fulltime training wherein there is a considerable increase in hours of dance, or with an increase in rehearsals close to final show time/eisteddfods.
- Change of dance surface e.g. hard floor or raked stage surface
- Poor foot biomechanics. How your foot moves when you are dancing. Does your foot collapse or roll in, or is it stiff with a high arch.
- Shortened deep calf muscles that ‘pull’ on the covering (periosteum) of the bone.
- Over use of tibialis anterior (muscle at the front of the shin) if the body weight is held back over the heels or with a sloppy walking pattern in thongs.
- Reduced dynamic pelvic control. This relates to how well you can keep the pelvis level while on 1 leg, hopping and landing from jumps.
SYMPTOMS
Pain is felt behind and/or in front of the shin bone. Tenderness is often localized along the bone and can be reproduced on touch or with weight bearing activities especially jumping. Deep compartment pain is often felt as a tightness which increases during exercise. Periostial (tissue covering the bone) pain however can often be worse after dancing.
DIAGNOSIS
Diagnosis will be made by your doctor or physio. A bone scan may be required and will show up ’hot spots’ and is preferable over an x-ray. These hotspots are areas of increased activity in the bone where it is trying to heal.
If there are any active hot spots it is very important to ascertain why the muscles are being overused and causing repeated pulling trauma. Therefore assessment and diagnosis should always include a lower limb and foot biomechanical assessment both static and with movement to highlight any weak links in the movement and support chain.
TREATMENT
Below are the main aims of treatment:
- Reduce inflammation- rest/ ice /anti inflammatory medication
- Foot control and strength exercises. Special emphasis applied to the small muscles of the foot and in the deeper muscles of the hip.
- Soft tissue release and home stretches for the calf and/or hamstrings and hips.
If stress fractures have occurred rest is indicated. Exercise which is low impact or non weight bearing is beneficial, such as swimming or Pilates.
RECOVERY
Recovery time is dependent on the length of time of the problem. If caught early pain can dissipate within a few days. For more chronic problems recovery may take a long time. Exercise modification is important while attempting to settle symptoms and may include strategies such as reducing jumps or wearing more supportive shoes for class.
PREVENTION
An assessment/screening at your local physio clinic, especially one versed in the requirements for dance, can assist in picking up any areas of weakness before they become problematic.
Written by Sally from PERFECT FORM PHYSIO – Suite 904/ 121 Walker St, North Sydney – Ph/Fax:(02) 9922 7721
