What are “shin splints”?
Shin splints appear on the medial (big toe side) and posterior (back side) of the shin bone. This is when the tibialis posterior muscle separates from the back of the tibia (shinbone). This shearing occurs when the bow begins to drop and the muscle is repeatedly overstretched with the pounding of running. It can be very painful and lead to worse injuries.
Who receives them?
People who run a lot get them… like lacrosse players. It usually happens when you ramp up your run and the body suddenly can’t repair itself fast enough for the tearing of tissues caused by the increased training.
Anatomical description:
The tibialis posterior extends from the top back of the tibia, down through the top of the foot to the inside of the ankle, to join the underside of a small bone that forms part of the arch of the foot. As the strike/run increases, each time the foot hits the ground, the arch gives a little. Every time this pulls on the muscle, it pulls it down along the back of the shin. This cutting or pulling can actually start to rip the muscle from where it attaches there. This causes pain, swelling, and weakening of the bone’s covering (periosteum). If this is allowed to go by long enough, the bone can weaken and lead to stress fractures as well as a complete fracture.
What else could it be?
Doctors need to have 3 differential diagnoses when analyzing the problem. When looking at shin pain, some things to rule out are:
1. Fracture (stress or frank)
2. Anterior compartment syndrome
3.Pathology- neoplasia…the big C. Rare, possible purpose.
X-ray findings:
The doctor may take an X-ray. It is not a bad idea. Make sure the pelvis is covered with a lead shield. Fractures and pimples can often be seen on x-rays. The same goes for neoplasia. Anterior compartment syndrome cannot be seen on x-ray. It is a potentially very dangerous problem and should not be allowed to “just go away”. That needs a pressure release procedure. See a doctor. Neoplasia, well, that would be a very sad thing, but fortunately it is quite rare.
State the difference between pimples and anterior compartment syndrome:
Shin splints are on the big toe side of the shin bone. This hurts when you start running, and in the early stages, the pain goes away once you warm up. I’ll talk, later, about how you can take care of much of this yourself.
Anterior compartment syndrome is found on the outside of the shin bone, toward the little toe. It will give you a feeling of fullness, heat and tearing pain. This needs immediate medical attention.
Is shin pain harmless?
Should I encourage my daughter to resist? Do not! If she is strong enough and left long enough, she can cause a weakening of the bone…leading to microfractures, stress fractures, and then total shattering of the tibia! Oh!
Take time off from the game?
That depends on how far you’ve gone! Demand moi. If we catch it early, then no, you don’t have to stop playing. I have some great ways you can help yourself through this, by playing all the time.
Personal care:
Materials:
oMake Dixie cup ice cubes. Yes, take a box and make a dozen, and store them in your freezer.
oTake 2 on the way to practice. Use it on the way out and one on the way back. Put the second in a cooler so that it melts to a minimum.
oA towel…hand size is ok
Traumeel ointment. I don’t sell this, but you can find it at http://www.heelusa.com
It’s a must have in your lacrosse bag! Awesome stuff for boo-boos!
Get arch supports!
I recommend the Spenco Full Length Soft Arch Cushion Insoles. They are soft, and that is important to many people. Look them up on the Internet. They shouldn’t cost more than $15.
Every morning:
After getting up and taking a shower, and walking around a bit: Do calf raises. You can hold on for balance as you: stand on one leg and tuck the other leg behind your knee. Push up to the tiptoe position and hold for a full 2 seconds. Repeat 20 times on each leg at first. Work up to 40 times on each leg.
What to do in the car on the way to practice:
Carry 2 dixie cup ice cubes in the car on the way to practice. Keep one in a cooler for after practice. Take the other one and peel back the lips of the cup so that the top of the ice cube is exposed, so you can grab the cup, not the actual ice cube.
Lay a towel flat on the floor of the car. Place your bare feet on the towel.
Use a Dixie cup of ice…about half on each pimple. Rub up and down on the painful area. It will drip all over the place. It will first feel cold. Then it will throb. Then it will fall asleep. This should take 3-5 minutes per side. Just use half of the ice cube on one side and go to the other.
The entire time you’re icing, tap your toes. That is to say: while rubbing the ice cube up and down, tap your toe as if impatient. You should do no less than 100 toe taps and no more than 200 on each side.
Now make sure the towel is flat on the floor. Use your toes to try to crumple the towel up into a ball. Make sure everything is wrinkled. It will take some work. Do this 3 times, straightening up between each “wrinkle.”
Now use the Traumeel. Use about an inch of the pomade. Divide it in half and rub half on each pimple.
Repeat this after practice on the way home.
Each night:
Do calf raises. You can hold on for balance as you: stand on one leg and tuck the other leg behind your knee. Push up to the tiptoe position and hold for a full 2 seconds. Repeat 20 times on each leg at first. Work up to 40 times on each leg.
If you do all of this every day in the morning, before practice, after practice, and before bed… your shin splints should go away within 2 weeks. If they are not, please contact me for more ideas.
