Lower Leg Anatomy For Shinsplints - Vital to Understand!

If you really want to overcome shinsplints, its vital you know as much anatomy of the lower leg as possible. Yet another example of how “knowledge is power.” Learn some anatomy and your chances of limiting shinsplints is greatly increased. 

Here I will show you a very important part of the lower leg, the tibialis posterior. This muscle causes so many athletes too much grief! (even if they dont know it.)The more you understand what is going on when you run, you will know how to actually adapt some better running habits. Now I am not a doctor, but I have been able to do this myself with good results. Its in your best interest to learn as much anatomy and physiology as you can.

 Below is a rear view sketch of the tibialis posterior. The main part of the muscle starts up near the back of the knee and comes all the way down behind (posterior) the tibia. Most important is where the tendon inserts - it wraps medially to the ankle and finishes on the inside of the foot. As you will see shortly, this is what defines its role.

Look closely at the muscle tendon that weaves down towards the middle of the foot-close to the arch of the foot. It sits inside the ankle and finishes (inserts) to the small bones of the foot called tarsals. This picture is not the clearest, but if you can get the overall picture that’s enough.

 You would have heard about the foot “rolling in” when you run. This is called INVERSION. The tibialis posterior is the PRIME MOVER of Inversion. If you look again at the anatomy above, it is totally logical for this muscle to control the amount of inversion during any activity. Think of its role as holding the arch of the foot up. This muscle undergoes much stress to keep the right amount of inversion during activity. 

The tibialis posterior in most runners I have seen, have chronic lesions most of the way through it. And while they can feel the pain is “in there somewhere”, most people can not locate it to do anything about it. Instead they might perform some “toe taps” and exercise the tibialis anterior because they think that’s the best thing to do. Why so many people still do this still shocks me. If shinsplints are caused by the stress of “rolling” when running/walking, then shouldn’t the focus be on treating the muscle that controls that movement?

The tibialis anterior is only the focus if the pain is located there-usually in people just getting back into exercise. For long term shin splint sufferers, the approach should be to learn about, locate and treat the tibialis posterior, not the tibialis anterior.

 Now you know exactly where the tibialis posterior is and what it does, your one step ahead of most people who continue to mindlessly do “toe taps” in the hope of something happening. It will not take the strain of the tibialis posterior or alter the amount of inversion when running. If we know the amount of roll is putting much pressure on this area, that should be our only focus in treatment. Sounds simple, yet the majority of people still do not take this approach. This is the kind of approach I take in my guide to treating shinsplints.

In the next entry I will talk about how I take this a step further to do something about the lesions throughout this muscle and get some releif for stabbing shin pain.

Shin Splints Article By Brad walker

Stretching And Shin Splints

Here is a shinsplints artilce I came accross written by Brad Walker of the stretching institute. He seems to think along the same lines as I do regarding shin splint treatment. So I thought I would post it for you to read…

Shin Splints

Shin Splints are one of the most
common injuries known to athletes.

Shinsplints are a term commonly used to describe most lower leg pain. However, shin splints are only one of several conditions that affect the lower leg. The most common causes of lower leg pain are: general shin soreness; shin splints; and stress fractures. For the purpose of this article, I’ll only be addressing the first two. I’ll save the topic of stress fractures for another issue.

Before I move on to shin splints, I want to quickly cover the topic of general shin soreness. Shin soreness is simply a muscular overuse problem. By using the R.I.C.E.R. regime outlined in a previous issue of The Stretching & Sports Injury Newsletter, you’ll be able to overcome 95 percent of all general shin soreness within about 72 hours.

For lower leg pain that goes beyond general shin soreness, a more aggressive approach must be taken. Lets now have a look at shin splints in a little more detail.

What are Shin Splints?
Although the term shin splints is often used to describe a variety of lower leg problems, it actually refers specifically to a condition called Medial Tibial Stress Syndrome (MTSS). To better understand shin splints, or MTSS, lets have a look at the muscles, tendons and bones involved.

As you can see from the diagram to the right, there are many muscles and tendons that make up the lower leg, or calf region. It’s quite a complex formation of inter-weaving and over-crossing muscles and tendons.

The main components of the lower leg that are affected by the pain associated with shin splints are:

• The Tibia and Fibula. These are the two bones in the lower leg. The tibia is situated on the medial, or inside of the lower leg. While the fibula is situated on the lateral, or outside of the lower leg.
• There are also a large number of the muscles that attach to the tibia and fibula. It’s these muscles, when overworked, that pull on the tibia and fibula and cause the pain associated with shin splints.

Specifically, the pain associated with shin splints is a result of fatigue and trauma to the muscle’s tendons where they attach themselves to the tibia. In an effort to keep the foot, ankle and lower leg stable, the muscles exert a great force on the tibia. This excessive force can result in the tendons being partially torn away from the bone.

What Causes Shin Splints?
While there are many causes of shin splints, they can all be categorized into two main groups. Overload (or training errors), and Biomechanical Inefficiencies.

Overload (or training errors): Shin splints are commonly associated with sports that require a lot of running or weight bearing activity. However, it is not necessarily the added weight or force applied to the muscles and tendons of the lower leg, but rather the impact force associated with running and weight bearing activities.

In other words, it’s not the running itself, but the sudden shock force of repeated landings and change of direction that causes the problem. When the muscles and tendons become fatigued and overloaded, they lose their ability to adequately absorb the damaging shock force.

Other overload causes include:

• Exercising on hard surfaces, like concrete;
• Exercising on uneven ground;
• Beginning an exercise program after a long lay-off period;
• Increasing exercise intensity or duration too quickly;
• Exercising in worn out or ill fitting shoes; and
• Excessive uphill or downhill running.

Biomechanical Inefficiencies: The major biomechanical inefficiency contributing to shin splints is that of flat feet. Flat feet lead to a second biomechanical inefficiency called over-pronation. Pronation occurs just after the heal strikes the ground. The foot flattens out, and then continues to roll inward.

Over-pronation occurs when the foot and ankle continue to roll excessively inward. This excessive inward rolling causes the tibia to twist, which in-turn, over stretches the muscles of the lower leg.

Other biomechanical causes include:

• Poor running mechanics;
• Tight, stiff muscles in the lower leg;
• Running with excessive forward lean;
• Running with excessive backwards lean;
• Landing on the balls of your foot; and
• Running with your toes pointed outwards.

How to Prevent Shin Splints!
Prevention, rather than cure, should always be your first aim. I was very surprised when researching this topic at the number of articles that totally neglected any mention of preventative measures. They all talked of treatment and cure, but only one out of twenty took the time to address the issue of prevention in any detail.

Even before any sign of shin soreness appears there are a number of simple preventative measures that can be easily implemented.

Since about half of all lower leg problems are caused by biomechanics inefficiencies, it makes sense to get the right advice on footwear. Your feet are the one area you should not “skimp” on. The best advice I can give you concerning footwear, is to go and see a qualified podiatrist for a complete foot-strike, or gait analysis. They will be able to tell you if there are any concerns regarding the way your foot-strike or gait is functioning.

After your foot-strike has been analysed, have your podiatrist, or competent sports footwear sales person recommend a number of shoes that suit your requirements. Good quality footwear will go a long way in helping to prevent many lower leg problems.

Apart from good footwear, what else can you do? I believe the following three preventative measures are not only very effective, but crucial.

Firstly, a thorough and correct warm up will help to prepare the muscles and tendons for any activity to come. Without a proper warm up the muscles and tendons will be tight and stiff. There will be limited blood flow to the lower legs, which will result in a lack of oxygen and nutrients for those muscles.

Before any activity be sure to thoroughly warm up all the muscles and tendons that will be used during your sport or activity. Click here for a detailed explanation of how, why and when to perform your warm up.

Secondly, flexible muscles are extremely important in the prevention of most lower leg injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement. To keep your muscles and tendons flexible and supple, it is important to undertake a structured stretching routine.

Stretching is one of the most under-utilized techniques for improving athletic performance, preventing sports injury and properly rehabilitating sprain and strain injury. Don’t make the mistake of thinking that something as simple as stretching won’t be effective.

For an easy-to-use, quick reference guide of 135 clear photographs of every possible stretching exercise, for every major muscle group in your body, get a copy of The Stretching Handbook. You’ll also learn the benefits of flexibility; the rules for safe stretching; and how to stretch properly. Click here to learn more about The Stretching Handbook.

And thirdly, strengthening and conditioning the muscles of the lower leg will also help to prevent shin splints. There are a number of specific strengthening exercises you can do for these muscles, but instead of me going into the details here, I have simply found another web site that has already done all the hard work. It explains a number of exercises you can do for preventing shin splints. You can find these strengthening exercises by going to http://www.watfxc.com/TF/TF%20Education/shin_splints.htm.

The above-mentioned article is the only other article I found that included a comprehensive section on shin splint prevention. If you’re only interested in the strengthening exercises, you’ll find them towards the end of the article. If however, you suffer from shin splints or you’re looking for more information on shin splints, I recommend you read the entire article.

How to Treat Shin Splints!
Firstly, be sure to remove the cause of the problem. Whether is be a biomechanical problem, or an overload problem, make sure steps are taken to remove the cause.

The basic treatment for shin splints is no different to most other soft tissue injuries. Immediately following the onset of any shin pain, the R.I.C.E.R. regime should be applied. This involves Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis. It is critical that the R.I.C.E.R. regime be implemented for at least the first 48 to 72 hours. Doing this will give you the best possible chance of a complete and full recovery.

The next phase of treatment (after the first 48 to 72 hours) involves a number of physiotherapy techniques. The application of heat and massage is one of the most effective treatments for speeding up the healing process of the muscles and tendons.

I have found, both from personal experience and from working with many clients, that this form of treatment is the most effective. The application of heat and deep tissue massage on the effected area seems to bring the best results. If you suffer from shinsplints, be sure to spend at least a few minutes massaging the effected area both before and after you exercise.

Once most of the pain has been reduced, it is time to move onto the rehabilitation phase of your treatment. The main aim of this phase it to regain the strength, power, endurance and flexibility of the muscle and tendons that have been injured.

—————————————————————————————-
Copyright © 1998-2007 The Stretching Institute™
Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more free articles
on stretching, flexibility and sports injury, subscribe to
The Stretching & Sports Injury Newsletter by visiting
The Stretching Institute.
—————————————————————————————-

Pronation Creates Tension Creates Shinsplints

Treating shinsplints can be very confusing for a lot of people. Not only are there multiple factors, it could be any combination of these factors that is causing YOUR shinsplints.

The best thing to do in the beginning is to break down the problem to its simplest form. Make sure you go over the basics and apply them so you can tick the common causes of your list as you progress. In other words, cover the basics well, and you will go a long way towards fixing the problem. If you decide to skim over the basics, it may be a longer and more frustrating recovery.

So what are the basic causes of shin splints? One of the main causes is pronation of the foot as it strikes the ground. Pronation is what most people see as “rolling in” when the foot strikes. Some people “roll” more than others and it is obvious when you watch them run.

Over pronation can be a main cause of tension, which is diagnosed as shin splints. Muscles and tendons pull away at the tibial lining, which causes inflammation.

If you are pronating a long way in relation to the upper leg staying normal as you run, the stress will have to show up somewhere. Exactly where depends on how much you pronate, your surrounding muscle strength and your foot type etc. But it will have to manifest somewhere along your lower leg.

A trained therapist can find where this tension has built up and use various techniques to treat it. I describe some of these in the shin splint cure report.

Being aware though, of pronation and tension build up from the early stages, is much better.

Arch supports are the most common way to minimise the pronation as you run. Most serious runners will know this, yet try one kind of arch support or new shoe and that’s it. You will need to keep trying different shoes and levels of support until you can really feel the soreness dissipate. Most people will not be lucky enough to strike the right arch support first attempt! Yet, athletes hope for this, and become disheartened when it doesn’t work first time.

Keep trying different arch supports and shoes until you get the right fit for you. Just a fractional change, can make all the difference to the soreness you feel after exercise.

So over pronation can be a common factor in manifesting shin splints. You must insure you get the right level of pronation first, regardless of how many attempts of arches and supportive foot ware you try. Simple in theory, yet how many athletes take the time to get this right? Your are un-likely to fix the problem your first attempt, but you’re much better off to stick with it and tick this of you list of causing factors of your shinsplints. For some people, simply eliminating pronation will eliminate shinsplints.

shinsplints

How I Treated My Own Shinsplints

Why am I making claims of a great shinsplints cure when so many of you have tried everything and had no luck fixing them?

I guess it is because I have been in the very situation you are, and what I know now, does not equal what I knew when I first had shinsplints. I took the same old advice and followed the same exercises that I see people following to this day - rest, stretch and do some toe pointing exercises. By doing this I was hoping something would fix the problem more than anything.

What I know now comes from diplomas in sports and remedial massage and working on hundreds of clients with shinsplints and other soft tissue injuries. It comes from being an athlete that was determined to beat this problem and apply the best techniques I learnt in the physiotherapy clinic. I had to take note of what really produced the result for people and how individual cases would differ. When I pieced everything together, I treated my shinsplints within 3 days and have not had a single re-occurrence. 

shinsplints are a soft tissue injury too!

I will tell you upfront one of the keys to treatment. So many people miss this vital point. Shinsplints are as much of a soft tissue injury as anything else. You must correct the soft tissue imbalances! Not only will it balance the problem long term, it will provide you with more short term relief than just about anything else.  

A simple “rub down” will not get this effect. But if you take the time to learn some massage techniques, similar to those a sports therapist would use, then you can get some real results at home. The best thing is you can actually feel these working strait away. If you can not feel relief then you may be doing something wrong.

As it is very hard, if not impossible, to stretch the muscles involved in shin splints, remedial massage techniques become twice as important. It is the only way to lengthen the soft tissue.

Without effective massage techniques, I could not have cured my shin splints. You either need to learn how to do this or pay someone to do it for you. The only problem with the latter is the frequency of treatment can add up costing you too much money.  

As long as you don’t do this…

You do not want to simply perform toe pointing exercises and keep running with the same form, for the same distance, as you have been up until now. I am not saying to completely stop these exercises as they are part of the overall treatment plan. But they are not the plan alone.

Whatever treatment routine you go for, you have to feel it working. If you cant feel an improvement beyond doubt in response to your treatment plan, then proceed with caution. Shinsplints have a way of going somewhat dormant so you start to think the problem has gone away. Then when you least expect it, they resurface worse than ever.

I have found shinsplints do not tend to fix themselves without the person actively following a treatment plan and monitoring the results. A good plan will involve soft tissue manipulation, a change in activity, making sure your shoes are right and closely monitoring your running action.

You can treat and manage shinsplints by following the right plan but just remember that it must involve effective soft tissue massage.