Shin Splints

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There are a lot of things that can be referred to as shin splints because they all cause pain in the shin.  Shin splints just means shin pain. 


I’m going to share some info about a type of shin pain that is pretty common and tell you some things you can do on your own to help with it. I’m also going to try and explain it in such a way that is eye opening and gets you excited in thinking about how you could use this information in new and experimental ways that could help improve your quality of life.


Okay, here goes…


One common cause of shin pain is hyper irritation of the tibialis anterior.  This is the muscle on the front of your leg, just to the outside of the bony ridge that runs from your ankle to your knee.


If someone has pain in the front of the leg that occurs particularly when hiking, running or walking downhill, and if that pain decreases during the activity…as the area gets “warmed up”…and is at its worst 24 to 48 hours after the activity, then this could be a very helpful thing to try.


Why does this muscle become hyper irritated on some people but not on others?  Nobody knows. I’ll tell you one of my ideas about it at the end of the article.  


How does it become hyper irritated?  That parts pretty interesting. The muscles in your lower leg pretty much all control the foot.  The tibialis anterior is on the front and it attaches to the foot in front of the pivot point, so when it shortens it lifts the foot up, toward the knee.


When you’re going downhill the tibialis anterior is engaged in a contraction while the muscle is becoming longer (an eccentric contraction, I’ll refer to it as eccentric activation to make it easier to visualize).  Eccentric activation happens when we set down an object, like putting a plate of dinner on the dining table. If our muscles weren’t activated then gravity would just take over and the dinner would land on the table pretty hard.


Likewise in our foot the tib anterior is lowering the front half of the foot in a controlled manner and keeping it from just slapping the ground with each step.  When you go downhill the tib anterior has a greater distance to cover, a longer eccentric activation. Which means less overlap of the filaments inside the muscle that slide past each other to make the muscle either shorter or longer.


It’s a quality of muscles that they get more tired when they have to work eccentrically than when they contract without motion or with shortening.  This is useful if you’re trying to find ways to work your muscles really hard. It also means that fatigue happens sooner in a muscle that is being asked to let go in a controlled manner through a large proportion of its possible range.  


As a bit of an aside, it’s also true that muscle strains are more likely to occur when a muscle is activating eccentrically.


Your muscle experiences fatigue when it bathes in the chemicals that result from doing work.  Perhaps it’s a way that the body has of getting us to rest so that it has a chance to adapt before injury occurs.


Whether it’s the chemicals or whether it’s some other condition of muscle fatigue, it’s a state that encourages (and happen more readily in some people than in others) hyper irritation.  This irritation always shows up in the same place in a given muscle and can cause mild to intense pain, often times in locations other than the hyper irritated spot. (These hyper irritated spots are referred to as trigger points.)


If you’d like to try relieving the potentially hyper irritated spot on your own tib anterior:
This image shows the location of the tibialis anterior trigger point that could be causing pain.

You can locate it by finding the bony knob below your knee cap and on the front of your shin.  Measure about 3 inches down from there and just to the outside of the shin bone. Press the muscle there and you might find a zingy spot.  If it’s causing pain it should feel quite zingy and tender. You can just hold some pressure on that spot for 90 seconds and see if the tenderness decreases.  If it doesn’t you can try holding if for a bit longer (up to three minutes), applying more pressure, or applying less pressure.


If it’s hard to find that spot you can rub the whole upper third of your tib anterior.  Something particularly tender might jump out at you and you can hold onto it for a minute or two.  You don’t have to get one super precise spot for this to work.


Other things you can do to help the situation.  


Apply heat to the upper third of the front of the lower leg.  Don’t apply ice.


Mobilize the lower leg.  

You can do this by making large toe circles (a good idea anyway for joint health).  Try to make them as smoothly as possible, not ratchety.  

Bend your knee and rotate your foot so the toes point toward your midline and then rotating so they point away from your midline.  The rationale for this is, well, movement is healthy and things can get to where they forget to move. And…that the muscle we’re working with attaches not just to the main shin bone (tibia), but also to the dense membrane stretched between the main bone and the outrigger (fibula).  So if we do a bit of twisting of the fibula relative to the tibia and if we move the lower attachment point around then the muscle is moving in ways that it doesn’t often move during our daily activities. Which is good.


My theory for why this happens, at least in part, and an interesting experiment for you to try.


Another quality of muscles is that when one group contracts, the nervous system tells the muscles that directly oppose them to stop contracting.  We make use of this when we do active stretching. (See my article where I talk about active versus passive stretching.)


The opposite motion from lifting up the front of your foot is pressing it into the ground.  So if we want to give the tib anterior muscle a little relief with each step we can try pressing the bottom of our foot down into the ground, particularly just before and during the push-off phase of the gait cycle.  We can also make a point of going through the full range of toe extension and plantarflexion (toe pointing) as we’re pushing off.  


There’s probably a tendency to not do much pushing off with the foot or not go through a full range of pushing off because of wearing stiff soled shoes or shoes that discourage ankle movement.  If the foot and ankle are immobilized we would tend to make up for it by requiring more movement from our knees and hips.


Anyway, that pushing off thing is not scientifically corroborated, but I think it’s a good idea…and worth trying.


I’m curious if this works for you, or what you notice as you play with it.  Let me know.

If this doesn’t work for you, there are other things that can be tried, so don’t despair.

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