Medial Tibial Stress Syndrome, aka shin splints, is responsible for 15% of all running injuries. Pain occurs over the inside border of the tibia. MTSS is a type of condition called traction periostitis. That means that a muscle repetitively pulls on the periosteum, which is the covering of the bone, and causes inflammation. A healthy bone will adapt to the stresses placed upon it. We know this as Wolf’s Law. But if the stress becomes excessive, the adaptation process can’t keep up and you end up with an injury like MTSS. Keep going, and it can progress to a stress fracture. In fact, they are seen as two points along the same continuum.
The mechanism behind shin splints is repetitive eccentric contraction of ✌ two muscles in the deep compartment of the leg, the tibialis posterior and flexor digitorum longs. Interestingly, increasing your speed too much is more detrimental than increasing your distance. A faster pace will produce extra shock that must be absorbed. The muscles will contract to stabilize your arch, but if they can’t, they will lengthen and become eccentrically loaded.
How injured the muscles are will determine how much you have to dial back, but the first thing you need to do is slow down. This will decrease the shock absorption required while the muscles recover. We’ve talked about why shin splints happen and shown you how to start the rehab process. This is a full sample plan for shin splint recovery.
Phase 1: You have to REST! In all the research we have on MTSS, nothing is more effective than rest. Remember the reason this happens is because your body’s recovery can’t keep up with the stress. So rest is key. If you try and push through, you increase the risk of stress fracture. During this time, you should focus on stretching the calves, the isometrics, as well as fixing the arches of your feet and strengthening the hips. Cross train to keep your fitness levels.
Phase 2: Begin a SLOW return to activity after 4 weeks. If pain comes back, return to phase 1 for 2 more weeks. Progress rehab to include light eccentrics and SMR with a lacrosse ball.
Phase 3: Prehab with proper cross training, a good warm up, and a structured plan with programmed rest to avoid recurrence.
For more info regarding shin splints, book online with one of our B&HC therapists today or give us a call at 1300 234 963.