By Mandy Eagar Shin splints is a layman’s term used to describe exercise-related pain in the lower leg. However the word does not imply a specific diagnosis. Rather it is a broad term that signifies pain over the anterior tibial area. As a number of conditions present with the same symptoms namely pain, swelling and inflammation it is important that the massage therapist establishes the aetiology of the symptoms prior to developing a treatment plan. In the absence of a proper diagnosis, the massage therapist should determine whether the muscles, the bone, or the attachment of the muscle is the actual source of the pain. Massage therapist, Mandy Eagar sheds light on the different types of anterior lower leg pain. Shin splints often involves damage to either of the two groups of muscles along the tibia. The location of the pain depends on which groups of muscles are damaged. The most common complaint is pain anterior to the tibia on the lateral edge but it can also occur medial to the tibia. This pain is described as sharp and is usually felt along the tibia while running or doing impact sport such as basketball and aerobics. It may be caused by training on hard surfaces, over-training, excessive uphill or downhill running, sudden increase in the duration or intensity of training and weak postural stabilizers i.e. core muscles including the back muscles and abdominal muscles and the gluteus medius in particular. The muscle attachments along the tibia become irritated and swelling may occur. The shin area becomes tender to the touch and palpation may reveal thickening of tissue along the tibia. The pain is experienced before, during and/or after exercise. Depending on the muscles involved, two types of shin splints are described namely anterolateral and posteromedial shin splints. Anterolateral shin splints In this case the front and outer part of the muscles of the shins are affected including the anterior tibialis. This muscle is prone to overuse due to its role in deceleration of the foot at the heel strike during the gait cycle. It is particularly affected by an increase in running distance. The pain is first felt when the heel touches the ground during running. Eventually the pain may become constant and the anetrotibial area becomes too painful to touch. Posteromedial shin splints Not only the anterior lower leg muscles can become affected, but also the posterior and deeper muscles of the lower leg and the posterior tibialis in particular. The function of the posterior tibialis is to support the arch of the foot as the body moves over the foot during the gait cycle. Posteromedial shin splints is usually caused by running in inappropriate or worn out footwear that...
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