Medial Tibial Stress Syndrome: Shin Splints

When stress is placed on the shins with physical activity from walking, running, or exercise, the connective tissues attaching the leg muscles to the tibia can become inflamed, causing medial tibial stress syndrome, more commonly known as shin splints. This inflammation is caused by tiny tears in the muscles and tendons of the shin. Chronic shin pain could be related to foot arch problems, underlying issues with the muscles, or shoes that don’t support the feet properly. Although it usually goes away within a few days, it’s important to monitor to ensure that it does not progress into a stress fracture. A chiropractor can offer treatments to relieve the pain and help prevent shin splints from recurring.

Medial Tibial Stress Syndrome

Medial tibial stress syndrome can impact anyone. It can come from walking far distances or in awkward positions like going downstairs with small steps, jumping rope, and playing with the kids on the playground can all cause burning, tightness, and pain in the shins. Shin splints affect individuals differently. For some, the pain recedes when the triggering activity is stopped. For others, the pain can become a chronic condition that results in continuous pain, even when at rest.

The Shin

• The shin is a part of the tibia bone in the lower leg.
• This bone absorbs the shocks when moving through daily activities.
• The muscles that run along the shin support the foot’s arch and raise the toes during movement.
• Medial tibial stress syndrome is caused by excessive force on the shinbone and the tissue around it, which causes the muscles to swell and increases pressure around the bone.
• If left untreated, small tears in the muscle and the bone can form, leading to chronic pain and stress fractures.

Medial tibial stress syndrome is more likely to happen from:

• Not stretching before physical activity or exercise.
• Constantly walking or running on hard surfaces.
• Wearing the wrong shoes that don’t provide enough cushioning or arch support.
• Over-exertion on the body with activity and movement.
• The body is not given the proper amount of time to recover.
• Athletes often experience shin splints when they’ve intensified their training routine or changed it up.

Symptoms

• Pain during exercise or activity.
• Pain in the front of the lower leg.
• Soreness in the lower leg.
• Swelling in the lower leg.
• Shin is hot to the touch.

Treatment

Whenever pain is being experienced, some muscles will either get tight or weak in response. By identifying the weak and/or tight muscles, a chiropractor can prescribe stretches and exercises that will help alleviate the pain and prevent it. One of the main principles of chiropractic is to treat the body as an interconnected system. A chiropractor may work on an unrelated part of the body to treat the symptomatic area. For example, they may work to align the spine and pelvis to lessen the impact on the lower legs.

Part of a treatment plan may include:

Soft Tissue Mobilization

• A handheld instrument loosens tight tissues during soft tissue mobilization therapy and breaks scar tissue around the tibia.
• Massaging tight muscles in the leg keeps them loose and alleviates the pain.
• Percussion massage can be added to reduce muscle knots, improve blood flow, and loosen up scar tissue.
• The treatment relieves pain and can help avoid shin splints when returning to normal activities.

Ultrasound and Low Laser Therapy

• Ultrasound and low laser therapy use heat to warm the deep tissues in the lower leg gently.
• The treatment eases pain, reduces inflammation, swelling, and increases blood flow.

Kinesio Taping

• Applying flexible Kinesio tape to the foot and lower leg can reduce stress on the shins.
• The chiropractor or physical therapist will show how to apply the tape correctly.

Foot Orthotics

• Individuals may be more likely to develop shin splints if they have high or low arches or their feet tend to roll inward or outward when walking.
• Prescription foot orthotics can be made to keep the feet properly balanced and supported.

Stretching Exercises

• Shin splints could be related to tight muscles in the back of the calf and weak muscles in the front of the lower leg.
• A chiropractor or physical therapist will show stretching and strengthening exercises to maintain muscle balance.

Body Composition

Retaining Water Due To Salt Intake

Salt/sodium is everywhere and hard to avoid.

It might not be a surprise that a single patty cheeseburger contains over 500 mg of sodium – almost a quarter of the daily recommended level, but it is a surprise to know that the ranch dressing on a salad contains as much as 270 mg or a tablespoon of soy sauce on a healthy, vegetable-only stir-fry has 879 mg of sodium. The Mayo Clinic estimates that the average individual consumes about 3,400 mg of sodium a day: close to double what is recommended. Sodium is linked with water retention, and it is the kidneys’ job to expel unneeded sodium out of the body. Until the kidneys activate, an individual will temporarily be retaining extra water. If daily water and sodium intake habits change daily, this can contribute to water retention, causing fluctuations in daily weight. So, if an individual was on a diet but flooded the body with more salt than usual, expect to see a temporary increase in weight.

References

Bates, P. “Shin splints–a literature review.” British journal of sports medicine vol. 19,3 (1985): 132-7. doi:10.1136/bjsm.19.3.132

Chiropractic Economics: The Science Behind Percussion Massage.

Gross, ML et al. “Effectiveness of orthotic shoe inserts in the long-distance runner.” The American journal of sports medicine vol. 19,4 (1991): 409-12. doi:10.1177/036354659101900416

Heer, Martina et al. “Increasing sodium intake from a previous low or high intake affects water, electrolyte and acid-base balance differently.” The British journal of nutrition vol. 101,9 (2009): 1286-94. doi:10.1017/S0007114508088041

McClure, Charles J. and Robert Oh. “Medial Tibial Stress Syndrome.” StatPearls, StatPearls Publishing, 11 August 2021.