With a stress reaction, the issue will worsen as you run and will feel worse after, and you may even experience a deep ache, or throbbing type pain at rest or at night in the more developed (stress fracture) types. Another give away is the behaviour of the pain. There will be a specific point of tenderness on the bone and in contrast to the muscular type injury this will be felt over a much smaller area – maybe 1-2cm. Similar to the muscular type pain the most common location for stress reaction/fracture is the lower part of the inner shin. Eventually, a stress fracture will happen. Ignore the pain and continue to stress the area then it can develop into a larger crack. When the excessive stress continues the bone may fracture microscopically – this is when you experience pain. If the level of stress being placed through them is greater than the rate at which the structures adapt, an area of bone weakness will develop. To briefly explain the process, our bones are constantly being remodelled to adapt to the stresses and loads placed upon them. You then have the bony type injuries, the two words that put fear into ever runners minds… s tress fracture (or reaction). But will be most sore at the beginning of a run and will often get easier as you get moving. A soft tissue problem generally won’t be painful at rest. Tibialis posterior/soleus pain is felt as a dull pain or real tightness typically along the distal 1/3 of the inner shin, into the soft tissues behind the bone. You can also develop inflammation to these muscles points of attachment to the bone via a structure called the periosteum (periostitis). As well as occasionally several other muscles in the area responsible for flexing of the toes. Namely the tibialis posterior and soles muscles. The most common type of shin pain I see is caused by excessive tightness or strain to the muscles occupying the medial shin area. This helps to guide the treatment and rehab. However, there are subtle distinctions in the presentation and behaviour of each. To make our lives more difficult you can have combinations of these.įirst we will focus on the most common, the muscular type injury.ĭifferentiating between these conditions can often be difficult, no less because they often co-exist. These include types of compartment syndrome and nerve related issues such as nerve entrapments in the lower leg, or referred neural issues from the lower back. There are also several other conditions which can manifest themselves as lower leg/shin pain. If these structures continue to be overworked and overloaded bony stress injuries can occur (reaction/fracture). Their attachment to the bone via a structure called the periosteum can become irritated and inflamed (periostitis). Often muscular shin pain can be caused by strain or excessive tightness to a number of muscles occupying the medial shin area. Shin pain can be broken down into four general categories muscular, bony, neural and vascular. The term ‘shin splints’ isn’t so much a diagnosis, rather a part of one of four conditions affecting the medial shin area, most commonly. From people just starting out at parkrun all the way through to the elites. This isn’t just something I see in those new to running either. It is one of the most common injury related phrases heard in the running world, so you would think it is fairly well understood, but often this isn’t the case. Starting with what happens, why it happens and finishing with how to treat it.Ī week rarely goes by where I don’t get someone telling me they have shin splints. Physiotherapist (and Irish international) Matt Bergin talks us through the dreaded world of shin pain.
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