Jumping, leaping, running on hard dance floors, basketball courts, or uneven surfaces can lead to shin pain on the front of the lower legs. Marissa experienced this after dancing for several seasons. The shin splints were so agonizing that she could no longer tolerate dancing. Sadly, Marissa had to cease the activity she loved the most and just rest.
What causes shin pain/shin splints?
Shin pain is due to irritation and inflammation of the tissue surrounding the bone (periosteum).
Intensive dance rehearsals and a high percentage of time dancing on hard floors increased the stress and pressure on Marissa's foot and tibia (shin bone) which she realized could cause myofascial tearing, and /or trigger points. As Marissa's muscles became fatigued they transfered stress to other soft tissues and bone. Marissa was concerned that repeatedly stressing her bone could lead to a stress fracture especially if she also had low bone mineral density. She knew that a stress fracture could lead to a complete bone fracture if activity were resumed too rapidly.
In addition to stress and tension, shin pain can be caused by improper biomechanical function of the foot or leg. Landing on the forefoot when running or overpronation (the foot rolls inward too much when landing, generally caused by flat feet.and/or knock knees) can cause shin splints.
Usually shin pain is worse at the beginning of an activity but it can occur up to hours later after the activity ceases.
Other athletes who also develop shin pain:
Marissa learned that not only dancers, but also hikers (especially ones doing a lot of down hill hiking), soccer and basketball players and runners,( esp ones who are increasing their mileage or intensity or changing the surface on which they are running) are all at risk for developing shin pain. They all engage in repetitive activities on a regular basis that puts excessive demands on the lower leg.
Assessing Shin Splints:
Although there is no visual indication, there is usually diffuse tenderness in the soft tissues around the tibia when one has shin splints.There are various tests that can be done to determine if the condition is actually shin splints - anterior shin splints;
or if it is posterior shin splints, (medial tibial stress syndrome (MTSS),
or if it is another condition such as:
anterior compartment syndrome,
stress fracture ( which an be caused by MTSS, muscle fatigue),
tendon, circulatory or nerve problems.
Treatment:
Marissa spent a lot of time, during her extended period of rest, discovering what additional treatments could bring relief and recovery. She found the following treatments beneficial.
- Massage techniques, performed in conjunction with active and passive movements
- Ice massage
- Ice packs, applied on and off for a few days
- Medications: anti-inflammatories
- Orthotics (shoe supports)
- Correcting underlying postural distortions that aggravate or contribute to the injury
- Rehabilitative exercises: (There were about 10 that she found beneficial.). She was also reminded of the value of being in good shape before beginning intense exercises which includes strengthening exercises.
After utilizing these treatments, Marissa was so pleased to be without pain that she leaped for joy.
Much of the information for the above article came from Whitney Lowe's books http://www.omeri.com/products/orthopedic-massage-theory-and-techniqu; and,
http://www.med.nyu.edu/hjd/harkness/patients/injuries/foot.html
