Saturday, 1 December 2012

Pain from Shin Splints? Learn About Treatment and Prevention

By Charles Leahy

Shin splints disrupt athletic training and are very painful. They occur due to an imbalance between the anterior and posterior tibialis muscles. When a person walks, the anterior tibialis is contracting to ease the foot down after the heel strikes. After heel strike, as the foot pronates, posterior tibialis must take over and aid with toe-off. These muscles must coordinate their actions for a smooth gait. If one fires a fraction of a second later than the other, it is essentially "torn" away from the bone in what is called microavulsion. This results in a great deal of pain for days after the injury. Depending on which side the microavulsion occurs on, pain may be felt on the front or back of the shin.

Isolating the cause requires some investigation. Simple causes include insufficient warm-up or running in sand. In more complicated cases, any anatomical misalignment or imbalance in the foot, ankle, knees, or pelvis can be a contributing factor. Frequent and prolonged sitting can also jam the 4th and 5th lumbar vertebrae, affecting the nerves which trigger these muscles to contract at the proper time. Essentially, the entire kinematic chain, from the feet to the head and jaw, must be considered in chronic cases.

Acute shin splints may respond well to mild massage toward the heart. Ice massage may be best in severe cases. It is important to rest after any flare-up. Essential fatty acids like cod liver oil manage inflammation when consumed. Persistant stretching is therapeutic and preventative when done before a race. I have two favorites. First, prop your foot up against a wall. Keep your leg straight and gently lean forward. This will stretch the posterior calf muscles. Next, place the back of your toes on the floor and gently press your ankle forward. This time a stretch will be felt in the front of the shin (anterior tibialis).

A proper diagnostic work-up should include manual muscle testing of each muscle involved, a visual gait assessment, neurologic exam, and shoe inspection. The chiropractic realm of medicine is especially well-equipped to address spinal issues (which are usually responsible for the timing problem). Shoe wear and gait should also be evaluated by a professional applied kinesiologist to get rapid and lasting results. For information on professional applied kinesiology, visit the International College of Applied Kinesiology online.

Once the muscles, spine, and shoes are corrected, proper warm-up should be sufficient in preventing recurrence. If swelling and/or extreme redness occurs, see a medical doctor immediately, as this is a sign of more serious pathology.

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