Prevention Better Than Cure?
WE DO BOTH!
18 Stepney Rd,
Scarborough,
YO12 5BN
01723 363332
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Prevention Better Than Cure? WE DO BOTH!
18 Stepney Rd, Scarborough, YO12 5BN 01723 363332 |
Shin Pain
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Shin pain is a common complaint in many individuals, mainly athletes. Many may
call this injury "shin splints" but this does not explain the cause.
Shin pain can involve one of three abnormalities 1) bone stress, which can lead to a stress fracture 2) inflammation, develops at the muscles insertions. Most common is the tibialis posterior and soleus attachments to the medial (inside) border of the tibia. 3) Increased intracompartment pressure, the fascia surrounding the muscles become swollen and painful. All three can occur together. Muscles affected The main muscles affected are tibialis posterior, tibialis anterior and soleus. The peroneals can also become tight and overworked causing a possible stress fracture of the fibula. Onset This injury can be sudden due to overuse, it can happen at the beginning of the season for certain sports (track athletes). A marked increase in training, changes in training surfaces, new exercises and new trainers can all contribute to the onset. Symptoms Most will feel a burning sensation during activity, followed by an ache at rest. A sharp pain maybe felt if trying to re-start a weight-bearing activity once pain is present. The injury can last from 1-6 weeks. You should use the following treatment advice to help shorten this time. Treatment To relive symptoms once present you can perform gentle stretching, ice massage is a nice pain relief after exercise, and taping could be used during training to help with the pulling sensation. Massage by a qualified therapist is very beneficial and they can then show you how to perform self massage correctly so you learn how to control the recovery of injury yourself. In mild case your running training should drop about 30 % and built back up slowly, if it is a more severe case drop to about 50% and use pool running or cycling to keep cv fitness and endurance. All other types of training should be fine to keep going, but monitor closely. To prevent the problem the problem you need to develop good dorsiflexion strength with a variety of motion planes. when running your foot does not always land straight in front, especially when on uneven surface. Exercises toe raises basic Resting against a wall raise your toes off the ground as far as you can towards your shin, keeping you heels on the ground. when lowering dont let your forefoot quite touchthe ground, repeat 15 times. Try shorter ranges of motion and increase the speed. Turn your feet outwards and inwards whilst lifting the toes to bring in some rotational strength. To advance You can try a single leg toe raise. Place one foot against the wall and fully support self on the other. Try heel walks with the toes pointing forward, outward and inward. You can increase to the speed or add in a little skip but make sure you are on a soft surface like sand. Bounces Jumping up on the spot. when you jump up pull your toes up towards your shins before landing. These exercises can be placed in your warm-up Try using a wobble board to help strengthen your shin muscles. Stretching Stretching will help to keep the range of motion required to fully absorb ground reaction forces. If exercise is not possible to warm the muscles up why not use a hot water water bottle before hand or massage. Then use ice after.
Both pictures are taken from http://www.walkinghealthy.com/Stretching/ShinStretches01.asp
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Biomechanical faults leading to shin pain
A rigid foot can increase the pressure on the bone as shock absorption is limited. Excessive pronation (flat arch) causes the compartments to contract harder and longer to resist pronation after heel strike. On toe-off they then work hard to contract to accelerate supination. With fatigue they will fail to provide shock absorption (can cause lateral shin pain).
Tight calf muscles increase the tendency to pronate as dorsi-flexion is limited. When dorsiflexion is limited the body will adapt by placing weight through the arch to reach the range of motion needed to disperse forces. However this will lead to the problem above. Follow this next link to find out about foot motions characteristics
www.runningwarehouse.com/. Possible injuries Stress fracture This is of gradual onset aggravated by exercise. Sometimes called 'crescendo pain. It can begin as an annoying irritation and becoming a throbbing torment as an individual continues to run. There is usually little numbness, weakness, or swelling, pain is usually not present when an athlete is at rest. Often, the bone will hurt when it is tapped near the damaged area, and occasionally a hard nodule will appear on the surface of the bone at the trouble site. A bone scan or MRI scan can confirm diagnosis
and professional athletes may require a CT scan to see whether there is a
facture line and make a better prognosis. A fracture will be painful during any
weight bearing activity, it will not ease off as it would for inflammatory shin
pain. Stress fractures also may be 'warning signals' for an underlying
nutritional or hormonal problem. Inflammatory shin pain Pain is usually along the medial border and will reduce with warming up. Training can usually be completed but pain will return after and the following morning. In severe episodes training will need to stop for 3-5 days before gradually introducing again. Pool training should be done during this time. Compartment syndrome The fascia surrounding the muscles become
inflamed which can lead to fibrosis and reduced elasticity. The muscles attempt
to expand during exercise but are unable to do so causing a feeling of tightness
or bursting sensation. Pain increases with exercise. Pain will usually be
accompanied by the two telltale symptoms of a compartment syndrome - numbness
and weakness. Numbness occurs because the excess pressure within a compartment
hampers the activity of sensory nerves carrying messages to the brain. As a
result, the runner with compartment syndrome may lose feeling in the 'web' of
the foot - between the first and second toes, or the insensitivity may extend up
the foot toward the ankle. Weakness is experienced because motor nerves carrying
impulses towards the muscles are also damaged by the high pressures within the
compartment. If a compartment in the front of the leg is involved, a runner may
have trouble dorsiflexing the ankle, and the foot may seem to flop loosely. In a
posterior-compartment problem involving muscles in the back of the leg, there is
often weakness when an individual tries to 'toe off'. References http://www.sportsinjurybulletin.com/archive/0161-shin-splints-treatment.htm Paul Goodyer. Techniques in musculolskeletal rehabilitation (2001). McGraw Hill. P.Brukner, K.Khan. Clinical Sports medicine. (2002) (revised 2ED). McGraw Hill.
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