Shin Pain

Shin splints is a general term used to refer to a painful condition in the shins. It is often caused by running or jumping, and may be very slow to heal.

Shin pain is a very common lower leg complaint that usually manifests itself as shin splints. Shin splints are characterized by pain in the front or side of the lower leg, particularly near the shin and often involve small tears of the leg muscle near the shin bone. It is especially common among people involved in athletic pursuits such as running and walking, although non athletic activities such as standing all day at work can also lead to shin splints. Symptoms include tightness, tenderness on palpation of the edge of the shin bone (tibia) and throbbing of the shins during and after activity. The symptoms often disappear at rest then return as soon as activity is resumed… & see the pictures

Causes of Shin Pain:

Overused Muscle
One cause is overused muscle, either an acute injury or DOMS (delayed-onset muscle soreness). The muscle pain is caused by any activity that involves running, jumping, and sometimes even swimming. An individual not accustomed to running may experience pain in the shin muscles the next day even after a single, short bout of intense running. There may even be immediate discomfort in the muscles from a build-up of lactic acid.

Inflammation of Connective Tissue
Shin pain may also be the result of inflammation of connective tissue such as periosteum (periostitis). The pain may be caused by a stress fracture in the bone or some other problem like osteosarcoma. Pain in the lower leg may also be referred from a distant area of the body, such as pressure on the sciatic nerve (sciatica) near the foot joint.

Chronic Compartment Syndrome

A problem which can mimic anterior shin splints is chronic compartment syndrome (CCS). This is a serious problem which can lead to significant loss of function in the lower leg. CCS occurs when swelling within the indistensible anterior compartment of the leg reduces blood flow. This relative lack of blood, ischemia, can cause more swelling and generate a positive feedback loop. In severe cases the result can be acute compartment syndrome (ACS) which requires emergency surgery to prevent ischemic muscle necrosis, muscle death due to lack of blood.
The purpose of the muscles of the anterior shin (tibialis anterior) is to dorsiflex the foot (raise the toe). It may not be obvious why a muscle which raises the toe can be stressed or injured by running, given that it is not responsible for propulsion. The reason is that unskilled runners overstride, and land heavily on the heel with each footstrike. When this happens, the forefoot rapidly slaps down to the ground. Effectively, the foot, which is dorsiflexed prior to making contact with the ground, is forcefully extended. This forceful extension of the toe causes a corresponding rapid stretch in the attached muscles. A reflex in the muscles responds, causing a powerful contraction. It is this eccentric contraction which leads to muscle soreness and possible injury to the muscle, tendon or connective tissue.

In a similar way, improper pronation of the foot during the footstrike can also cause pain in the muscles which oppose pronation, on the inside or outside of the shin. In proper pronation the foot strikes the ground on the outside of the heel and then rolls toward the inside of the foot approximately 5%. The ideal degree of pronation varies slightly with the individual. It is determined by factors such as the height of the arch (a higher arch has more clearance for pronation than a low arch) and the flexibility of the arch. In over pronation, the foot rolls in too far. The result is that the foot pushes off almost entirely from the big toe, causing excessive strain on the big toe and the outside of the shin. In contrast, under pronation occurs when the foot does not roll enough. This causes the entire weight of the foot strike to concentrate on too small an area on the outside of the foot, which places a corresponding strain on the shin.

It is also commonly believed that a contributing cause of shin muscle pain in some cases is the relative weakness of the muscles on the anterior of the lower leg compared to those in the calf. In this case, exercises that preferentially strengthen the anterior muscles may help alleviate or avoid shin splints. The shin pain is attributed to a forced extension of the muscle, in this case by the opposing calf muscles which “overpower” the shin.

Bikers who have to use their feet to change gears or apply brakes can suffer from shin splints after long rides.

1.A sudden increase in activity is the most common cause either when first starting an exercise program or when increasing distances to quickly.

2.Exercising on hard surfaces.

3.Tight lower leg muscles.

4.Exercising in shoes with inadequate support and/or cushioning.

5.Biomechanical factors such as excessive pronation of the foot are considered to be significant contributing factors in the cause of shin pain. When the foot contacts the ground taking all our weight it begins to flatten (pronates) to absorb the shock of our body weight hitting the ground. One of the important muscle groups helping to control this motion are the muscles in our shins. When the foot flattens too far these muscles are overworked and become fatigued and painful. The muscle attached along the inside of the shin bone is the tibialis posterior muscle which is over worked when the tibia internally rotates as a result of this excessive pronating of the foot. The over repeated contraction of the muscle on the tibia bone will eventually cause irritation then pain.

Think of CCS when pain worsens steadily during exercise rather than improving as the ligaments and muscles warm. Tingling in the foot is a particular red flag; it indicates compression of the nerve.

If a bone problem is suspected to be causing inflammation of connective tissue, a bone scan can be useful in confirming the diagnosis.

Shin Pain -Modern Treatment & Prognosis
The aim of the treatment is to reduce the amount of the excessive pronation (flattening) of the foot which will in turn reduce the internal tibial (shin) rotation. This will reduce the over action of the tibialis posterior muscle which is one of the main causes of shin pain. An orthotic does this best by controlling the excessive pronation and flattening of the arch of the foot. Podlink orthotics offer excellent shock absorption due to the material used in the heel region and will restore the foot and its posture to the right biomechanical position.. The foot will adapt to this biomechanical posture reducing the symptoms quickly.
1.Reduce or stop exercising for a period of time to allow inflammation in the shin area to subside.
2.Icing the affected area.
If you suspect CCS seek medical attention before continuing to train. If you suspect ACS, seek medical attention immediately night or day.

Acute treatment
The immediate treatment for shin splints is rest. Running and other strenuous lower limb activities like soccer and other sports which include flexing the muscle, should be avoided until the pain subsides and is no longer elicited by activity. In conjunction with rest, anti-inflammatory treatments such as icing and drugs such as NSAIDs may be suggested by a doctor or trainer, though there is some controversy over their effectiveness. Some people will use acupuncture to treat shin splints though there has not been any conclusive or comprehensive study in the effects of acupuncture on shin splints.

Prevention :

Like any muscle, the muscles of the anterior shin can be trained for greater static and dynamic flexibility through adaptation, which will diminish the contracting reflex, and allow the muscles to handle the rapid stretch. The key to this is to stretch the shins regularly. However, static stretching might not be enough. To adapt a muscle to rapid, eccentric contraction, it has to acquire greater dynamic flexibility as well. One way to work on the dynamic flexibility of the anterior shin is to subject it to exaggerated stress, in a controlled way. If the muscle is regularly subject to an even greater dynamic, eccentric contraction than during the intended exercise, it will become more capable of handling the ordinary amount of stress. Experienced long-distance runners practice controlled downhill running as a part of training, which places greater eccentric loads on the quadriceps as well as on the shins. A professional trainer or coach, or perhaps a sports medicine doctor, should be consulted before engaging in this type of training.


The long-term remedy for muscle-related pain in the shin is a change in the running style to eliminate the overstriding and heavy heel strike.

Most competitive runners do not strike the ground heel first. Sprinting is performed on the toes, as is middle-distance running. In long-distance running, the footstrike should be flat, though some elite long-distance runners will retain their forefoot strike acquired from years of competing in track-and-field.

Correcting the footstrike begins with posture. A hunched forward posture leads to a heel strike.

In both postures, the center of gravity is directly over the foot. Physics requires this, because it is the condition which prevents a body from falling over. An object falls over when its center of gravity shifts too far one way or the other outside of the range of its supporting base. Arching the back shifts the body’s center of gravity toward the rear, so that the legs must tilt forward to compensate, bringing the weight to the toes. Bending forward at the waist has the opposite effect: the legs tilt back at the ankle, shifting weight to the heels.

During running, the center of gravity changes dynamically. Because much of the time there is a drive leg extending backward, the torso appears to tilt forward to compensate for this. This forward tilt is similar to what happens in a standing position when one leg is raised from the ground and extended backward. Inexperienced runners witness this forward tilt in professional athletes and imitate it by bending at the waist, which isn’t the same thing. In the forward tilt, the torso and extended leg still form a straight line, or even a slight backward & see the pictures



Stress on the shin muscles can also be somewhat alleviated by footwear and choice of surface. Runners who strike heavily with the heel should look for shoes which provide ample rearfoot cushioning.[dubious — see talk page] Such shoes may be referred to as “stability” or “motion control” shoes. The so-called “neutral” shoes for bio-mechanically efficient runners may not have adequate support in the heel, because the runners for whom these shoes are intended do not require it. When their cushioning capability degrades, the shoes should be replaced. The commonly recommended replacement interval for shoes is 500 miles (800 kilometers). Excessive pronation can be reduced by extra supports under the arch. Running shoes which have a significant supporting bump under the arch are called “motion control” shoes, because they work by limiting the pronating motion. Also shoes with cushion shock features and shoe inserts can help prevent further problems.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies


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