Shin Splits (medial tibial stress syndrome)

Running season is upon us. For some, it means trying an event like the Sydney Bridge Run for the first time. For others, it signals the start of training for The City 2 Surf. As Sydney Osteopath George Asproukos explains, pushing too hard can lead to pain in the front part of your shin bone.

One of the most frustrating issues I encounter with athletes and runners is shin splints. This common pain arises during and after activities that involve repeated running. The discomfort is mainly felt at the front or sometimes the back of the shins. Clinically, shin splints are referred to as medial tibial stress syndrome. Patients often experience significant tenderness along the inside border of the shin bone.

What are Shin Splints?

There is ongoing debate about the exact source of the pain, but the general consensus is that shin splints result from a stress reaction in the bone or the connective tissue sheaths around the shin bones, known as the periosteum. The repetitive stress from running can overwhelm the body’s ability to compensate, leading to inflammatory changes in the tissues and a stress response in the bone.

Why do Shin Splints Happen?

Shin splints are primarily an “overuse” issue. Repeated running sessions that exceed the shin's capacity to handle bio-mechanical stresses trigger symptoms and changes. This often occurs at the beginning of a training program or when increasing training intensity. A key factor that many people overlook is recovery time. With adequate rest between sessions, the body can repair itself and prevent lasting damage.

Certain bio-mechanical foot postures can increase the risk of stress on the medial insertions of the periosteum. Individuals with these postures may develop shin splints more easily or experience recurring episodes. Inappropriate footwear can also contribute to this condition. Additionally, specific training regimens—such as sprint training, running downhill, or running for extended periods on uneven surfaces (like the camber of a road)—are linked to shin splints.

What Can You Do About Shin Splints?

Rest is crucial. Ensure you take adequate time off between running sessions. Consider incorporating other activities that reduce repetitive running loads on the shins, such as weight training, swimming, or cycling. Weight training can even enhance the shin's ability to handle stress, while stretching activities like yoga may also be beneficial. If you continue to experience issues with shin splints, or if the pain persists, seeking a professional assessment and a tailored plan could be advantageous.

What Will an Osteopath Do for My Shin Splints?

As an Osteopath, I will conduct a comprehensive assessment and develop a tailored plan that suits your specific situation and training needs. This plan will include experienced hands-on treatment aimed at providing symptom relief in the meantime.

Will It Go Away?

With time and appropriate management, shin splints almost always resolve. However, you may need to reduce your activity level or lower your expectations for completing that marathon in three weeks. It’s common for individuals with chronic or recurring episodes of shin splints to require professional assistance in finding a resolution.

What’s the Worst-Case Scenario?

In some susceptible individuals, repeated aggravations can lead to stress fractures in the shin or a more serious condition known as compartment syndrome. This occurs when pressure in the shin builds up, potentially damaging nerves and restricting blood flow. In extreme cases, surgical decompression of the shin muscular compartments may be necessary. However, this is a rare complication.

Conclusion

Understanding shin splints is essential for anyone involved in running or high-impact sports. By recognising the signs, knowing the causes, and implementing preventive measures, you can significantly reduce your risk of developing this painful condition.

George Asproukos Osteopath