What is Shin Pain?

Pain in the front of the shin is commonly referred to as “shin splints”.

However, there can be different sites for this pain, and the treatment and management of each of these varies.

The three sites are: 
  •       Muscle.
  •       Attachment of muscle to bone.
  •       Bone.

In each case the pain comes on mainly because of overuse, but it can result from changes in training routine, footwear, or ground surface. It is usually always associated with abnormal biomechanics – that is

  1.     A very flat type of foot.
  2.     A very high arched rigid foot.

 

Muscle Pain

The symptoms are usually an ache and a feeling of tightness. It worsens with exercise and eases with rest. Pain may be experienced in the front, anterior muscles or in the back, posterior muscles.

Treatment consists of rest, ice and physiotherapy.

It is also important to alter the cause, such as changing footwear or training routines.

Corrective insoles to change the position of the foot on the ground should also be provided.

 

Bone: muscle attachment pain

The symptoms here usually occur after exercise or the next day, and tend to decrease when you warm up during exercise.

The treatment of this is similar to the treatment for muscle pain, in that rest and physiotherapy are used, although the techniques used by the therapist will differ a lot.

Non-steroidal anti- inflammatories (obtainable through your GP) can be useful here.

Again, changes in footwear and training routines may be needed and corrective insoles (orthotics) should again be prescribed by your physiotherapist.

 

Bone Pain

When the bone is the source of the pain the main symptoms will be an ache at night, which is sometimes increased in the morning.

Bone pain will be aggravated by exercise and impact (e.g. heel strike or jump on foot) and tends to be very sharp and localised in one spot. In severe cases there can be a stress fracture of the tibia (shin bone).

Treatment here is mainly rest and a graduated monitored return to exercise. It is essential in these cases that a biomechanical assessment is carried out and orthotic insoles provided to help increase shock absorbency and prevent recurrence of injury.

 

Treatment:

Correct Footwear

Different types of footwear suit different sports. Always seek advice from reputable stockists when choosing footwear.

Biomechanical Assessment

Have feet accurately assessed in relation to biomechanics of the whole body so that if orthotics are required the correct type will be ordered.

Ice Treatment

Ice in the acute stages is always the first approach to treatment, so before you even contact your physiotherapist get started on your ice routine. Remember 20 minutes often is much more effective than prolonged icing.

Taping 

Kinesio taping may help

Local Physiotherapy Treatment

Physiotherapy treatment of the area will reduce pain, reduce inflammation and increase healing.                      

Stretching

Accurate stretching should be used. This should be done as warm up and cool down from sport, but also as a form of treatment.

Strengthening

Care should be taken when strengthening as part of rehabilitation, as if the wrong exercises are undertaken, or if they are carried out at the wrong stage of rehab the condition may be flared up.

Gait Re-education

It is frequently the biomechanics of walk or run that causes the problem, so these need to be accurately assessed and re-educated.