{"id":2664,"date":"2020-06-18T14:00:00","date_gmt":"2020-06-18T13:00:00","guid":{"rendered":"https:\/\/movementandwellbeingclinic.co.uk\/?p=2664"},"modified":"2021-06-14T17:30:51","modified_gmt":"2021-06-14T16:30:51","slug":"medial-tibial-stress-syndrome","status":"publish","type":"post","link":"https:\/\/movementandwellbeingclinic.co.uk\/medial-tibial-stress-syndrome\/","title":{"rendered":"Medial Tibial Stress Syndrome"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">You wake up to see a beautiful, sunny morning and consider going for a pleasant, stress-relieving run. You limber up and contemplate the mileage you\u2019re about to undertake before you feel shin pain. <img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2665 alignleft\" src=\"https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/06\/Screenshot-2020-06-10-at-13.53.51-300x199.png\" alt=\"\" width=\"300\" height=\"199\" srcset=\"https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/06\/Screenshot-2020-06-10-at-13.53.51-300x199.png 300w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/06\/Screenshot-2020-06-10-at-13.53.51-1024x679.png 1024w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/06\/Screenshot-2020-06-10-at-13.53.51-768x509.png 768w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/06\/Screenshot-2020-06-10-at-13.53.51.png 1466w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/span><span style=\"font-weight: 400;\">This soon turns into pain every time your foot hits the ground and doesn\u2019t seem to want to go away. If this happens repeatedly during medium-to-high impact exercise, it&#8217;s only natural to be concerned. You start to Google, and your pain starts to sound like Medial Tibial Stress Syndrome.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">What is this it? Will it go away soon so <\/span><span style=\"font-weight: 400;\">I<\/span><span style=\"font-weight: 400;\"> that you can continue running? We aim to answer these questions in this blog.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What is Medial Tibial Stress Syndrome?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Shin Splints, otherwise known as Medial Tibial Stress Syndrome, is an exercise-induced injury. Pain typically occurs during movement that requires excessive force of the foot dorsiflexors (the muscles that bring your toes up towards your knee) (1). It is a very common issue, which is present in 4% to 19% of athletic populations (2). It isn\u2019t a serious condition and will often improve after seeing a competent manual therapist.<\/span><\/p>\n<h4>Why does shin pain occur?<\/h4>\n<p><span style=\"font-weight: 400;\">Medial Tibial Stress Syndrome primarily occurs due to the body not being used to the load being applied to it. Below are other risk factors:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Increased range of ankle motion<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Navicular drop (dropped arch)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Orthotic use<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">High BMI<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Female gender<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">External hip rotation<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Previous occurrence of Shin Splints (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK538479\/\">McLure &amp; Oh, 2021<\/a>)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The reasons behind these risk factors are unclear; however, it is assumed that a lack of foot arch and increased range of ankle motion causes Shin Splints due to the lack of a rigid lever that absorbs ground forces. Also, a high BMI score will inevitably cause more weight to be transmitted through the feet, thereby causing more pressure being exerted on the muscles of the shin.<\/span><\/p>\n<p>\u00a0<\/p>\n<h2><span style=\"font-weight: 400;\">How is shin pain resolved?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Shin Splints treatment starts out with activity modification and exercises. The good news is that it rarely requires surgery. Considering the abundance of information, I have compiled a list of various treatment options and how they have performed in studies.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Stretching &amp; strengthening<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Daily stretching with eccentric calf training has been shown to work until symptoms improve. Abdominal, gluteal and hip muscle strengthening can improve your running mechanics and prevent other lower leg injuries.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Footwear<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Good quality, shock-absorbing footwear can reduce the incidence of Shin Splints, as long as they fit properly, you haven\u2019t drastically changed your footwear type and you replace them every 250-500 miles.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For more information, please see our blog <\/span><i><span style=\"font-weight: 400;\">\u2018\u2019What <\/span><\/i><a href=\"https:\/\/movementandwellbeingclinic.co.uk\/what-running-footwear-should-i-be-using\/\"><i><span style=\"font-weight: 400;\">running footwear<\/span><\/i><\/a><i><span style=\"font-weight: 400;\"> should I be using?\u2019\u2019<\/span><\/i><\/p>\n<h3><span style=\"font-weight: 400;\">Orthotics<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Orthotics could help, but as stated in this blog, they could contribute to causing\u00a0 Shin Splints.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Manual therapy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Manual therapy for this purpose consists of holistic, kinetic chain correction and spinal\/pelvic realignment. This needs to be done alongside other interventions (mainly exercise-based).<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Balance training<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Proprioceptive, or balance training, can help to increase the efficiency of postural stabilising muscles and improve the body\u2019s reaction to running on uneven surfaces.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Extracorporeal shockwave therapy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Extracorporeal shockwave therapy has shown to have mixed results (with only a small minority of good quality research studies proving its\u2019 effectiveness) and can be expensive.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Injections<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Cortisone (anti-inflammatory medication) has been shown to work but, like in most cases, this should be used as a last resort due to the long-term effects on the body. For more information please see our blog <\/span><i><span style=\"font-weight: 400;\">\u2018\u2019Should I get a <\/span><\/i><a href=\"https:\/\/movementandwellbeingclinic.co.uk\/should-i-get-a-steroid-injection\/\"><i><span style=\"font-weight: 400;\">steroid injection<\/span><\/i><\/a><i><span style=\"font-weight: 400;\">?\u2019\u2019 <\/span><\/i><span style=\"font-weight: 400;\">(5).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hopefully this <\/span><span style=\"font-weight: 400;\">is<\/span><span style=\"font-weight: 400;\"> answers a lot of your questions.<\/span><\/p>\n<p>\u00a0<\/p>\n<p><span style=\"font-weight: 400;\">For any further questions, please don\u2019t hesitate to ask:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">0161 209 2980<\/span><\/p>\n<p><a href=\"mailto:info@movementandwellbeingclinic.co.uk\"><span style=\"font-weight: 400;\">info@movementandwellbeingclinic.co.uk<\/span><\/a><\/p>\n<p><span style=\"font-weight: 400;\">Ed Madeley M.Ost<\/span><\/p>\n\n\n<p> <strong>References <\/strong> <\/p>\n\n\n\n<ol><li> Merskey H, Albe Fessard D, Bonica JJ, Carmon A, Dubner R, Kerr FWL, Lindblom U, Mumford JM, Nathan PW, Noordenbos W, Pagni CA, Renaer MJ, Sternbach RA, Sunderland S.&nbsp;Pain terms: a list with definitions and notes on usage. Recommended by the IASP subcommittee on taxonomy.&nbsp;PAIN&nbsp;1979;6:249\u201352 <\/li><li>Glitsch, H. G.,<em> Electrophysiology of the sodium-potassium-ATPase in cardiac cells. Physiol Rev. 2001 Oct; 81(4):1791-826<\/em><\/li><li>Alban Latremoliere,&nbsp;Clifford J Woolf (2009) <em>Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity <\/em>2009 Sep;10(9):895-926. doi: 10.1016\/j.jpain.2009.06.012.<\/li><li>Finan PH, Goodin BR, Smith MT (2013) <em>The association of sleep and pain: an update and a path forward.<\/em>J Pain.; 14(12):1539-52.<\/li><li> Rev Neurosci. 2017 Feb 1;28(2):203-218. doi: 10.1515\/revneuro-2016-0067.  <\/li><\/ol>\n\n\n\n<ol><li><\/li><\/ol>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>You wake up to see a beautiful, sunny morning and consider going for a pleasant, stress-relieving run. You limber up and contemplate the mileage you\u2019re about to undertake before you feel shin pain. This soon turns into pain every time your foot hits the ground and doesn\u2019t seem to want to go away. If this happens repeatedly during medium-to-high impact exercise, it&#8217;s only natural to be concerned. You start to Google, and your pain starts to sound like Medial Tibial Stress Syndrome. What is this it? Will it go away soon so I that you can continue running? We aim\u2026<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_uag_custom_page_level_css":""},"categories":[34],"tags":[],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":5}},"acf":{"info_box_title":"Additional information","info_content":"<strong>Summary<\/strong>\r\n<ul>\r\n \t<li>Should be suspected if you experience:\r\n<ul>\r\n \t<li>Pain in the lower shin bone region<\/li>\r\n \t<li>The pain worsens with exercise, particularly running and jumping movements<\/li>\r\n \t<li>Almost immediate improvement after rest<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>It occurs in 4%-19% of athletic populations, with a third of new runners and 20% of dancers developing it<\/li>\r\n \t<li>What works:\r\n<ul>\r\n \t<li>Strength and conditioning program<\/li>\r\n \t<li>Graded running program<\/li>\r\n \t<li>Postural alignment<\/li>\r\n \t<li>Extracorporeal shockwave therapy (not offered here)<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>What doesn't work\r\n<ul>\r\n \t<li>Massage therapy, stretching or foam rolling<\/li>\r\n \t<li>Compression socks (mixed)<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>If left untreated:\r\n<ul>\r\n \t<li>It's unlikely to improve<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>"},"featured_image_urls":{"full":"","thumbnail":"","medium":"","medium_large":"","large":"","1536x1536":"","2048x2048":""},"post_excerpt_stackable":"<p>You wake up to see a beautiful, sunny morning and consider going for a pleasant, stress-relieving run. You limber up and contemplate the mileage you\u2019re about to undertake before you feel shin pain. This soon turns into pain every time your foot hits the ground and doesn\u2019t seem to want to go away. If this happens repeatedly during medium-to-high impact exercise, it&#8217;s only natural to be concerned. You start to Google, and your pain starts to sound like Medial Tibial Stress Syndrome. What is this it? Will it go away soon so I that you can continue running? We aim&hellip;<\/p>\n","category_list":"<a href=\"https:\/\/movementandwellbeingclinic.co.uk\/category\/sports-injury-clinic\/\" rel=\"category tag\">Sports Injury Clinic<\/a>","author_info":{"name":"Ed Madeley","url":"https:\/\/movementandwellbeingclinic.co.uk\/author\/mrosteo\/"},"comments_num":"0 comments","uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false},"uagb_author_info":{"display_name":"Ed Madeley","author_link":"https:\/\/movementandwellbeingclinic.co.uk\/author\/mrosteo\/"},"uagb_comment_info":0,"uagb_excerpt":"You wake up to see a beautiful, sunny morning and consider going for a pleasant, stress-relieving run. You limber up and contemplate the mileage you\u2019re about to undertake before you feel shin pain. This soon turns into pain every time your foot hits the ground and doesn\u2019t seem to want to go away. If this&hellip;","_links":{"self":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/posts\/2664"}],"collection":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/comments?post=2664"}],"version-history":[{"count":0,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/posts\/2664\/revisions"}],"wp:attachment":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/media?parent=2664"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/categories?post=2664"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/tags?post=2664"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}