Around this time of year, Djimmer starts to see many Shin Pain patients. In light of this Djimmer has been kind enough to publish a quick breakdown of what the most common causes of shin pain are, and what to look out for.
If you're in pain, read the article below and feel free to contact Djimmer at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
with any questions.
Shin pain is a common complaint among athletes, particularly runners. The main causes of shin pain are medial tibial stress syndrome (MTSS), or “shin splints”, tibial stress fracture and chronic exertional compartment syndrome.
Many of the disorders are overuse injuries; contributing factors include too much activity, inadequate strength and flexibility, muscle imbalance, inappropriate running surface and terrain, lower extremity malalignement and inappropriate footwear.
Proper diagnosis can be challenging and is reliant upon a thorough history, including training history, especially recent changes in mileage, footwear, intensity and running surfaces. Focus should be on pain onset, relationship of pain with specific activity, associated symptoms such as cramping or numbness and alleviating or aggravating factors.
Medial tibial stress syndrome or shin splints is the most common description of shin pain but often times misdiagnosed. Other terms to describe this condition are periostalgia, medial tibial periostitis and traction periostitis.
MTSS is thought to be an overuse injury of the muscle tendon units of the deep posterior compartment, as well as periosteal inflammation of the medial tibia. The exact pathofysiology is not well known. The 2 muscles most likely contributing to MTSS are the posterior tibialis and the soleus.
Clinically MTSS usually presents itself as localized palpable pain at the medial border of the distal 3rd of the tibia. Pain is initially mild, progresses with exercise and decreases with rest. In advanced stages or with continuous exercise, pain may develop earlier and not decrease at all with rest.
Physical examination will show a diffuse area of pain along the medial border of the distal tibia. Pain will be reproduced with dorsal flexion or with resisted plantar flexion. In more severe cases swelling, thickening or nodules may be palpated.
If the diagnosis is unclear, radiographic imaging tests may be done and they should come back negative.
Treatment includes relative rest to allow the inflammation to subside and the tissue to heal. Patient can continue non weightbearing cross training, such as bicycling, swimming or running in the pool, as long as this is painfree.
NSAID’s (non-steroidal anti-inflammatory drugs) or anti-inflammatory modalities such as ice massage, ultrasound or e-stim can be used in acute stages.
After the acute stage, strength and stability exercises should be started, addressing faulty body mechanics that result in overuse of the muscles in the anterior and posterior compartments. A proper bio-mechanical assessment is a necessity to prevent future flare ups and development of a chronic problem.
Djimmer Bosman, PT Clinic Director,
Ascent Therapy Clinics and Wellness Centers- DTC
7939 East Arapahoe Road,
Suite 270
Greenwood Village, CO 80112
phone: (720)529- 4802
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
This e-mail address is being protected from spambots, you need JavaScript enabled to view it
www.AscentWellnessCenters.com
|
