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Portland Chiropractor - Shin Splints

Brad Farra - Monday, June 07, 2010

What are shin splints and how did I get them?

As a sports chiropractor in Portland I see a lot of running injuries.  Shin splints is one of the most common running injuries.  Shin Splints is an entirely too vague of a term describing exercise induced lower leg pain.  The term shin splints is used by runners to describe their symptoms or by a doctor as a diagnosis.  Shin splints is essentially the strain of a muscle and its attachment to the tibia.  A more specific term would be tenoperiostitis or traction periostitis.  There are two types of shin splints, posterior and anterior.  Posterior shin splints are on the inside (medial) side of the shin and it's also called postero-medial shin splints or medial tibial stress syndrome.  Posterior shin splints involve the tibialis posterior, flexor digitorum longus, and the flexor hallicus longus muscles.  Anterior shin splints, also called antero-lateral shin splints, involves the tibialis anterior muscle. 

Shin splints is a repetitive/overuse type of injury.  The primary factor in both anterior and posterior shin splints are weak muscles/tendons.  This weakness leads to damage/degeneration of the soft (connective) tissues that connect the tendon to the periostium of the bone; hence the term tenoperiostitis.  When repetitive muscle contraction, of one or more of the above mentioned muscles, is too forceful this painful condition results. 

Repetitive impact is the most common cause of shin splints.  Shin splints is not limited to running, but you can bet there is probably running involved in the sport if shin splints is an issue.  Several factors play a role to increase the likely hood you will have problems with shin splints:  long distances, hills, hard/uneven surfaces, training errors (too far, too fast, too soon), changes in routine, new activity, inappropriate shoes, poor conditioning, inadequate warm-up, over pronation/under controlled pronation, and over training.


How can I prevent shin splints?

Prevention questions are among the most important questions I answer as a Portland Chiropractor.  I work with a lot of athletes in a preventative manner.  The most important thing you can do to prevent shin splints is to not make any training errors.  Don't run too much, too fast, too soon.  The most common training errors are when you increase your mileage or speed too quickly.  This also includes avoiding over training. 

There are specific exercises that can be done to help prevent shin splints.  It's simple:  Strengthen the muscles listed above as the culprits in shin splints.  Running on softer surfaces lessens the impact on the leg and in turn decreases your vulnerability to shin splints.  If you run on uneven surfaces, as in trail running, make sure you build mileage slowly so your body has time to adapt to this type of stress.  Always be sure you get an adequate warm-up before your running event, especially if your sport involves sprinting.  Have a coach look at your technique and consider using a technique that can help decrease the impact stresses on your leg/shin.

Treatment of shin splints:

The treatment of shin splints usually involves temporarily limiting or stopping the offensive activity.  The most effective therapy for shin splints involves the use of Graston Technique, ice, rehab exercises,stretching, and kinesio-taping.  Proper evaluation of the entire kinetic chain should be performed by a qualified practitioner.  Manipulation of the low back, SI, knee, ankle, and foot joints can also be helpful.  The athlete can also use a compression sock or have the shin taped for running.  A change in shoes may be helpful.

There are many other factors that should also be addressed with shin splints; these issues include foot positioning at foot strike (foot flair), hip position (externally rotated hip), stride length (too long of a stride), and leg length inequality.  Weak quads, hamstrings, hip abductors, or hip flexors can also be a factor with an athlete suffering from shin splints.

How long will my shin splints last?

When you start feeling the pain of shin splints the condition has more than likely been going on for a significant amount of time.  If you seek treatment immediately after you start feeling the pain the condition should significantly improve in 1-2 weeks.  If the condition is chronic it could take months to resolve.  Treatment should continue after the resolution of pain to reduce scar tissue/adhesions.  If you are being treated for shin splints and are not seeing improvement consider one of the other possible causes for shin pain listed below.  Be sure that all of the factors listed above have been addressed.

All shin pain is not shin splints!

Other shin pain that is NOT shin splints:

-Tibial Stress fracture

-Compartment syndrome

-Intermittent claudication

-deep vein thrombosis


If you have any questions about shin splints or other running/sports injuries feel free to comment on this blog.  If you live in the Portland area and need treatment for a sports injury or have any questions please visit my website:  www.drbradfarra.com