Shin Splints

In the running community we have all heard of shin splints. This is the generic term for a condition (Medial Tibial Stress Syndrome) that gives pain along the shin. Like the Achilles or plantar fascia, shin splints is one of the most annoying injuries to pick up and one I’ve suffered from in the past. Why is this? Because you can most likely keep running with it for longer than you should!!

Typically, it is a bit sore starting out on a run but eases after a few K’s, and it may be sore when you stop. The more you run the longer the pain lasts, until it is sore throughout the whole run and even after your run has finished. The pain is usually hard to pinpoint and seems to travel down the shin bone.

Most worryingly, this condition is along a spectrum of bone stress injuries, culminating in a stress fracture. It’s believed the force/load applied to the bone while running is exceeds the bones ability to withstand it. This means the bone can’t remodel(fix itself) adequately. With increased load(more running), the development of a stress fracture becomes more likely.

A stress fracture can de differentiated from shin splints based on someone’s history, gender, training status, along with the location of pain. A stress fracture is much more focal. The pain can be singled out at a particular point. It doesn’t like impact! Even walking can become a problem.

What’s to be done with your Shin Splints?

In both cases, there is a need to reduce the load (time on feet) to an acceptable level. A plan needs to be put in place to address the underlying causes of the injury. This would involve building up the load tolerance of the bone through weightbearing and non-weightbearing exercises. The more you progress, the more you need to load the bone to stimulate healing and adaption.

Prevention is better than cure!

Runners tend to strength train everywhere but the lower limb(knees down). Therefore, we increase our chances of injury in this area. Exercises that I incorporate into my S&C plan are the following:

  • Straight leg heel raises (gastrocnemius)
  • Bent knee heel raises (soleus)
  • Step ups(glute max)
  • Side lying hip abduction (glute Medius)

Of note, Vitamin D is also beneficial for bone health.



Patellofemoral Pain-Physical Therapy

Patellofemoral Pain

Patellofemoral pain (runners knee) is an insidious injury that kind of creeps up on you. It affects both athletes and non athletes alike. It typically presents as pain in or under the knee cap. This makes it very frustrating as you can’t quiet put your finger on it. The cause of patellofemoral pain (PFP) is likely multi factorial, with different factors contributing to varying degrees in each individuals pain. Uncovering which factors contribute to the pain presentation is challenging.

Continue reading “Patellofemoral Pain-Physical Therapy”

Iliotibial Band Syndrome (ITBS)

ITBS

Iliotibial band syndrome is a common overuse injury which causes lateral knee pain among runners, cyclists and endurance athletes.

The ITB is a taut band of connective tissue which attaches superiorly into the fascia of the TFL and Gluteus maximus muscle. It travels down the lateral leg attaching into the linea aspera of the femur. At the knee it attaches to the lateral femoral condyle (LFC), Lateral femoral epicondyle, Gerdy’s tubercle of the tibia and the head of the fibula. Continue reading “Iliotibial Band Syndrome (ITBS)”

Tendinopathy

Tendinopathy

is described as an overuse tendon pathology. The Achilles, rotator cuff, patella and elbow extensor tendons being the most commonly affected. Much research into how to best manage tendon pathology is currently evolving. This research is based on the continuum model presented by Cook and Purdam. This model describes 3 stages of tendon pathology (tendinopathy). Reactive, disrepair and degeneration stage. (Cook et al, 2008). Continue reading “Tendinopathy”

Plantar Fasciitis

Review: Loading The Plantar Fasciia

High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up

Plantar Fasciitis is a condition that affects both active and non active populations. It is characterised by medial heel pain were the plantar fascia attaches to the calcaneus (heel). It is particularly painful with the first few steps in the morning and after long periods of inactivity, (Jariwala et al, 2011).

Plantar fasciitis was thought to be an inflammation of the plantar fasciia, however current thinking considers it a degeneration of the collegen matrix, with similar markers to a tendinopathy, (Burchbinder,  2004, Lemont, 2003). Recent research into tendinopathies have shown that load management specific to the phase of the tendinopathy can have better patient outcomes with regard to pain and function (Cook & Purdam, 2009). Continue reading “Plantar Fasciitis”

Barefoot Running

The publication of the popular book “Born to Run” by Christopher McDougall, has led to massive interest in and experimentation with barefoot running. Shoe manufacturing companies have taken advantage of this new phenomenon by developing minimalist shoes which gives the user a close to barefoot experience. The central theme driving the adoption from shod foot to barefoot is the hypothesis that it improves running economy thereby saving energy and injury risk reduction. However there is little high quality evidence to support this hypothesis. Continue reading “Barefoot Running”