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The word 'shin splints" is a catch-all phrase for shin pain on walking or running There are three main causes of shin splints.
1. Medial Tibial Stress Syndrome (most common)
2. Tibial Stress Fractures
3. Overuse compartment syndromes
Medial tibial stress syndrome is commonly seen in athletes who suddenly increase their duration or intensity of training. This type of shin splints may also be seen in athletes who have very high demand training levels, such as marathon runners, even if their training levels are not dramatically increased. It results from either sustained stress to the inner aspect of the tibia, which can precede an actual stress fracture, or when the outer surface (periosteum) of the medial tibia is irritated by the close attachments of the soleus and tibialis posterior muscle.
On the outside of the shin lies the tibialis anterior muscle covered by an envelope of tough fascia. If the muscle becomes over-developed (through increased training), or its size is increased by greater blood flow in response to exertion, the fascia constricts the muscle. This is known as compartment syndrome. Blood supply to the muscle is reduced, resulting in pain, pins and needles, or numbness if the blood flow to the nerves is also affected. With rest, these symptoms should resolve fairly quickly but are likely to reoccur whenever exercise that involves impact such as running is donen. Damage to the muscle and then bleeding into the compartment can produce similar symptoms. (If you experience neurological symptoms, ask advice from a GP as if left untreated, it can lead to more serious problems.)
Shin splints are caused by overloading or excessive physical stress of some sort. Some health practitioners say it is because the runner "over-pronates" while others insist the problem stems from the angles of the knees, or the positioning of the pelvis. The reasons vary because every case, like every person, is different.
You might be advised to take a break from training and adopt a non-weight-bearing exercise regime – a stationary bike, for example – to help maintain fitness levels until you are able to start running again. Your osteopath will look at the balance of the muscles at the front and back of the legs. In some cases over tight calf muscles may be involved and need to be stretched. There are osteopathic tecnhniques to loosen a tight fascial compartment. Overpronators may need an orthotic (but see also : Pronation of the foot)
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