Shin Splints, Anterolateral Shin Splint, Posteromedial Shin Splint

A shin splint is a painful condition that occurs from damage to muscles along the shin, and the pain can occur anywhere from just below the knee to above the ankle. The typical cause is continued, repeated stress to the lower leg, and is common in runners.

Shin splints may be caused by:
• An inexperienced runner just beginning to run (too much too fast).
• Running on side slopes (ie. banked tracks).
• Tight Calf Muscles, exerting extra force on shin muscles.
• A sudden change from soft to hard running surfaces.
• Poor or worn out footwear.
• Excessive uphill running.
• Poor running mechanics. This could include: heavy forward lean, excessive weight on the ball of the foot, running with toes pointed outward, landing too far back on the heels causing the foot to flap down, and overpronation. Of all of the possible causes, pronation (foot roll) is the most likely to be overlooked.

Anterolateral Shin Splints

Anterolateral shin splints affect muscles in the front and outside parts of the shin, and is the result of a natural imbalance in the size of opposing muscles. Shin muscles pull the foot up, whereas the large and powerful calf muscle pulls the foot down everytime the heel strikes the ground when running. These calf muscles can exert a lot of force, enough force that can actually injure the shin muscles. Anterolateral shin splints will cause pain in the front and outside of the shin. Initial pain is felt when the heel strikes the ground though eventually the pain just stays constant.

To allow this type of shin splint to heal, the person must stop running and do other kinds of exercise recommended by their doctor or physical therapist. Such exercises usually involve stretching the calf muscle, as tight calf muscles put a lot of pressure on the shin muscle and tendons. A constant regimen of ultrasound is commonly recommended to help massage the affected muscles and tendons, allowing them to heal more quickly and reduce inflammation and pain in the area. Treatment of the calf muscle with ultrasound will also help increase the flexibility of this muscle, thus indirectly reducing the average level of strain on the shin muscle and tendon group.

Posteromedial shin splints

Posteromedial shin splints affect muscles in the back and inner part of the lower leg. These muscle groups are responsible for lifting the heel to support the runners weight on the ball portion of the foot when running. This type of shin splint is often caused by running on a banked track or non-level running surface or wearing improper shoes that do not protect the foot from rolling (pronation). Pain begins on the inside of the lower leg (usually within 7 inches above the ankles), but will worsen and continue to rise up the leg. Initially, only tendons of the muscles will become inflamed, but if running continues, the muscles themselves could become affected. At the worst, the tendon could become detached from the bone - a painful occurrence that causes bleeding and excessive inflammation.

To allow a posteromedial shin splint to heal, the running must temporarily stop running and do other kinds of exercise recommended by their doctor or physical therapist. Special shoes may be prescribed during the healing phase, and it may be advisable to look into potential problems with pronation of the feet. This can often be solved by researching and using shoes that better prevent pronation and/or the avoidance of running on side slopes.

Tips on Tendinitis

The strained tendon is a common yet painful injury that will occur in almost everyone at least once in their lifetime. The trick with a strained tendon is to make sure it heals properly which will provide the lowest chance of reinjury. Reinjury of a strained or stressed tendon occurs more easily than the first time and there is usually much more inflammation around a reinjured tendon than there was during the first occurrence of the injury. Tendonitis is a degenerative condition in the tendon fibres that attach muscles to bone, and sufferers generally complain of a severe, burning pain in the area, which gradually worsens and is exacerbated by stress on the joint.

If you got it from a workout, heavily reduce your workout intensity (eliminate it altogether if possible) through the healing stage, and make sure the injured tendon be warmed up (and down) properly before and after a workout where it will be stressed. When treating tendinitis, rest the area, apply ice for 10-20 minutes at a time for at least 3 times a day. Do this to the injured area for the first day up to 3 days. Moist heat may be used after the acute swelling is improved and rest prevents further muscle injury. Ice will reduces initial inflammation and swelling and the moist heat circulates blood through the area to speed the healing process. This can be further helped by the use of ultrasound applications over the affected area, as it reduces swelling quickly and increases blood flow to the area. If the patient gradually starting flexing and mobilising the area, the muscle would probably heal very well.

However, this is not what typical person does; they may ice once or twice and rest a bit, but most often just take some pain relief pills and continue to commence their activities. If the strain was minor, their body may be able to heal the muscle fibers normally. Unfortunately, this is not the usual result because the injured muscle is being used instead of rested. Because of the stress on the muscle, their body heals the injured muscle fibers by binding them together with fibrotic adhesions or scar tissue. This is done in an attempt to prevent further damage to the injured area and is a normal protective response of their body.

To prevent scar tissue buildup the patient should apply ultrasound treatment on the area up to three times daily (ask your doctor!). Ultrasonic energy will naturally "work" the tendon, increasing its flexibily while softening and breaking down scar tissue - which is not something you want in your tendon. Scar tissue is inflexible (non-elastic), and can quickly lead to reinjury of the tendon later down the road. If you choose to use steriod injections or are using steriod injections, do NOT treat the area with ultrasound until 30 days after the last injection. Steriod injections break down the tissue in the treated area in an attempt to get it to re-heal properly. Applying ultrasound over areas injected with steriods may increase the damage and can potentially tear the tendon.

The trick to any tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of tendon fibres as possible - something radiant energy and ultrasound are great at! Even with optimum healing there is always less elasticity in a previously injured tendon. The trick is to make sure you heal this the best you can, that way your chance of reinjury down the road is much lower than average - which is well over 50%.