Shin Splints

I’m a physical therapist in Northern Virginia. When treating shin splints it is much like putting a puzzle together. You need all of the pieces in order to complete the puzzle. Treatment is much the same. Shin splints can be related to core weakness, hip weakness, inflexibilities, weakness at the foot/ankle and/or biomechanical errors.

Oftentimes, core and hip exercises are given to prevent increased lateral pelvic tilting. The greater the hip drops on one side, the more the knee is forced inward and more pronation can occur at the feet. Check out the following video: http://www.90revolutions.com/biomechanics/specificfaults/biomechanicalfaultofback.html. Example exercises include gluteus medius strengthening, planks, sidelying planks, and lunges with rotations.

Tightness of certain muscles can contribute to shin splints. The most common tight muscle is the gastrocnemius (main calf muscle). If the gastrocnemius is tight, increased pronation occurs at the feet. A tight soleus (another calf muscle) may also contribute. If these muscles are tight, a runner’s stretch may be necessary. This pronation (landing on the inside of the foot) may also be related to foot function.

If foot function is the main contributor, then the appropriate shoe wear and insoles must be used. I oftentimes see patients after they have had past physical therapy without long-term results. The most common neglected treatment is addressing poor biomechanics. If the foot lands improperly, an over-the-counter insole or custom orthotics is needed. Running technique must also be assessed to rule out any contribution to the symptoms.

I hope this short synopsis clarifies treatment and causes of shin splints.