The first thing to do is to get prompt medical assessment from a Sports Physician or Physiotherapist who have a specific interest in running. Your stubborn efforts to keep running can often be rewarded with at least 6 weeks of enforced rest and having to wear an Aircast boot! You might find yourself with a case of MTSS which progresses to a full-blown fracture. Ignoring shin pain and trying to ‘push through’ the pain rarely achieves anything other than making symptoms worse. Pain will be worse in the morning and pulling your toes up towards your shin will be painful. When problems first start, you might only experience pain at the beginning and end of the run. You may have noticed in runs prior to having shin pain, that you experienced a sense of tightening in the calf muscles. MTSS typically results in pain that is felt more broadly along the length of the medial border of the tibia. Pain and ‘awareness’ of your shin at night is another feature that would raise the suspicion of bony injury. If when you prod your shin you find that you have very focal tenderness that is between 1 mm and 1.5 cm in size, this can be a sign of bone stress injury. Pain which is very well-localised on palpation of your shinĪ tibial bone stress injury often results in marked pain on weight bearing activities, which gets more intense with activity, and NOT better once ‘warmed up’.Pain that worsens specifically on weight bearing activity (e.g.The 3 red flag signs for a bone stress injury are: There are thankfully tell-tale signs associated with each injury. The only iron clad way of differentiating between the two is to have an MRI scan (not an x-ray – which frequently miss stress fractures). Differentiating between shin splints and a bone stress injury A fast engine plus too much mechanical stress to your relatively underdeveloped musculoskeletal chassis can result in injury. If you have recently started running, having come from an established endurance background, such as cycling, then your well-developed cardiovascular engine can sometimes mean that you are more prone to ramping up the mileage quickly. This all adds up where impact and stress on the body is concerned. They are associated with repetitive impact that occurs with regular running – especially when increasing mileage, introducing speed work or even a ‘HIT’ class. These muscles can be felt if you run your fingers down the back of the inside edge of your shin.īone stress injuries range from a bone stress reaction to a complete bone fracture. MTSS is caused by repetitive traction and inflammation of the posterior tibial muscles, which attach to the posterior medial tibial border. There are a number of causes of shin pain, but the two most prevalent are ‘shin splints’ (aka medial tibial periostitis or medial tibial stress syndrome – MTSS) and bone stress injuries (which can culminate in a stress fracture). Shin pain is a common complaint amongst distance runners.
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