Sock Doc video on shin splints treatment and prevention. For the post, click here.
Hey, this is Sock Doc. Today I’m going to talk about a common running injury called shin splints. So shin splints are the pain that you had maybe once in your life, maybe in high school, maybe you’ve got it now where you’ve got pain in the lower leg usually in the front of your lower leg, your sort of shin muscles there next to your shin bone. And usually the prescribed treatment is the good old Dixie Cup.
You take a frozen Dixie Cup, cut off or scrape off the bottom of the Dixie Cup and rub that Dixie Cup up and down your shin muscles there to hopefully relieve some of the pressure and pain in there that’s keeping you from running or walking comfortably. Well, as usual there’s better ways to take care of the problem and hopefully preventing it from happening again or if you don’t have it at all hopefully from preventing it from ever occurring to you.
So let’s talk about the shin muscles. Coming down here to your lower leg you’ve got two major players with this injury. Your tibialis anterior muscle which lies to the inside of your shin bone which is known as your tibia, comes all the way down, wraps through the top of your foot. And then you have your tibialis posterior muscle which sits in the back of your shin bone, again your tibia and this is the one that I talked about in the plantar fasciitis video. It comes all the way down from the back of your leg here, I’ll show you more in a minute, all the way down to the arch of your foot.
So you’ve got an imbalance between these two muscles and that’s why the pain persists. Now what will either happen is one of two scenarios. Either the muscle in the front, the tibialis anterior will spasm because of the one in the back being weak, the tibialis posterior or vice versa. The tibialis posterior might spasm because the tibialis anterior is weak.
So think of it maybe in more simple terms is if your bicep muscle isn’t functioning well then your tricep is going to be the one that’s tight and spasming. And your inclination might be to go and rub out your tricep because that’s the one that hurts where the problem is really on the other side of the weak muscle. And this is just a reflection of that weakness.
A very similar situation here in the lower leg. You’ve got the muscles in the front and the back of that tibia bone, the shin bone the anterior and the posterior tibialis muscles and those aren’t cooperating well. They’re not functioning well together. So there is an issue usually in one or the other of them, sometimes both. And that’s causing you to have anterior or posterior shin splints meaning you have pain somewhere in one or the other. When that gets worse enough sometimes people are even diagnosed with what’s called compartment syndrome and sometimes surgery is recommended. Usually it’s not a very good thing to do and rarely necessary and doesn’t even address the problem anyway.
So let’s get back to what we talked about before in some other videos is the most effective way to treat these is not the ice and not from stretching because remember stretching pulls muscle fibers away from one another. It elongates them. When you have an injury you want to look for the area of tenderness, those trigger points, to push those muscle fibers back to one another to get them to heal faster and line the muscle fibers back up. We don’t want to stretch them. That’s one of the major Sock Doc rules.
So we’re looking for trigger points in our tibialis anterior or our tibialis posterior muscles. So what that means is come down here. Tibialis posterior actually starts a little bit behind your fibula bone which is that bone on the outside of your lower leg. You’re going to look in here, down just a little bit, but especially more to the inside of your lower leg. So just below the crease of your knee search in here and then, so we’re here and then you’re going to come around and go right down the tibia bone on the inside here or really all the way down with your thumb just along the inside of the tibia bone, all the way down to about here looking for any tender spots.
So those are the trigger points. And any sore spots you might have here with your thumbs you’re going to rub them out, light circular motion, or you can even hold them all the way down to the arch of your foot here where it supports the arch of your foot is about where the majority of that muscle ends. And you’re going to help to hopefully reset those muscles and break up the adhesions in there so the muscle fibers can join back together and heal.
Now the tibialis anterior, same type of thing. You’re looking for the trigger points but now more on this side of the tibia bone, more towards the outside of your leg. You’re coming just down the inside of your tibia with your thumb looking for any sore spots. Sometimes it might feel like it’s right on the bone. And come all the way down to about right here, maybe just about where your ankle joint starts there. And look for those tender spots.
Now some people even can get stress fractures there or feel like they have stress fractures because their shin splints are so bad. So that’s what you’re looking for, those trigger points in that area.
Again, don’t be stretching. Don’t be putting your, you know, the ball of your foot on a stair or anything like that and dropping your heel down to stretch them out. It’s not a good idea. So you’re looking for that imbalance between the front and the back. And usually that’s justified by any sore spots in there that you can rub out in a trigger point, in doing trigger point therapy.
So another major issue in getting over your shin splints and hopefully preventing them if you’ve never had them is your shoes because wearing non-
minimalist shoes especially shoes with a very high heel will put you in the position when you’re running and you’re landing on your heel like this rather than more mid- or forefoot land as you’re landing and pushing off on your foot.
So think about if you’re constantly pounding like this the stress that’s going to put on your tibialis anterior muscle here and start to create your shin splints if you’re constantly running and landing like this.
Whereas if you’re wearing more minimalist shoes or walking or running barefoot you’re always going to be landing like this and dispersing that weight and the balance, the force, throughout your foot and up your leg normally and not just concentrating it on specific muscles that aren’t used to handling so much force and impact.
So make sure your shoe is very minimalistic, very low, very low heel to fore foot drop. Again, and that usually means the heel isn’t built up much and very little support in the shoe which means no anti-pronation devices, no, you know, no extra support, no extra cushion. And be walking barefoot as much as you can to strengthen your feet.
That also means as you know no orthotics. So orthotics are going to support dysfunction of your feet. They might make you feel better while you’re in them because it’s supporting the muscle and imbalances in there, but they’re not going to correct anything. And often over time a new injury will result that you might not associate with your orthotic use. It could be in the other leg, it could be even in your upper arm from wearing an orthotic and obviously in your foot.
I talk about this in some of the gait articles on Sock Doc. Orthotics will support the dysfunction of your foot and they’ll support gait imbalances. They don’t correct anything. So your goal is to get out of those. Work your way out of those as quickly as you can, as comfortably as you can, and start strengthening your feet by wearing minimalist shoes and going barefoot.
So that’s one of the obviously the main principles to get rid of your shin splints and to hopefully keep yourself injury free. Also remember to evaluate stress levels. If you’re training too hard, if you’re training anaerobically, if you’re racing too much, too high of a heart rate, under too much stress which can include dietary stress from an improper diet -
too many carbohydrates, not enough protein, bad fats in your diet, all things I address on the Sock Doc site.
That’s how people get injured. You get injured from being too anaerobic and that could mean either the training is too anaerobic or there’s too much stress in your life creating anaerobic excess. And that’s really how people get injured. They get injured from basically trying to handle more than what they can. And that results in injuries along possibly with the wrong type of footwear.
So back to training aerobically, eating well, staying well-hydrated, walking barefoot. Look for those trigger points in your lower leg, maybe where the shin splints are or maybe on the opposite side. So if its anterior shin splints remember to look in the back. If you have posterior shin splints which might sound like Achilles tendonitis to you, maybe not, but look in the front. It could be a very similar type of injury.
Remember it’s important to diagnose why you have something rather than what you have. So someone might tell you have Achilles tendonitis. Someone might say, “Oh, that’s posterior shin splints.” It really doesn’t matter in the long run. You’re going to hopefully figure out where those points are that you need to address and address it more at the source rather than at the symptom. And look for those factors that may have evolved in your life to create this injury. Hope you enjoyed it. Thanks.