By Calvin Sim, Senior Physiotherapist, Back2Sports
Have you had pain in your shin that does not go away with rest? These shin splints are common complaints of runners, especially those who run often on hard surfaces, a typical enough situation here in Singapore. Unlike other injuries where you feel pain in the muscle, ligaments or joints, the pain from shin splints actually comes from the bone in most cases; or more accurately, from the periosteum, which is a thin sheath that covers all bones whose function is to be provide nourishment to the bones. This sheath is rich in nerve endings, so it feels pain. When the periosteum is overstrained and irritated, it gets inflamed causing pain. In the case of shin splints, it is the sheath covering the tibia.
What pulls at the periosteum?
Most of the muscles in the calf, ankle and foot attach directly to the shinbone. When these muscles do not work well or work too forcefully, it strains the periosteum covering the shinbone. Causes include:
Repeated strain onto the periosteum will lead to the inflammation, causing the pain.
Treating Shin Splints
The best way to treat shin splint is to remember RICER (Rest, Ice, Compression, Elevation, and Referral). Completely rest and ice the painful region immediately when pain is first felt. Compress and elevate your leg above your heart if there is swelling and get a medical professional to review your condition.
For each of the above causes of shin splits:
A course of anti-inflammatory medication can help decrease your pain. A sports physiotherapist may also tape your ankle or shin to reduce the pulling force of the periosteum.
A final word of warning, chronic compartment syndrome can also cause shin splints, where pressure builds up within the muscle and restricts blood flow. This requires immediate medical attention as restricted blood flow can lead to nerve and muscle death. Whenever any type of pain persist, it is always prudent to seek proper medical advice.