Treatment & Prevention of Shin Splints with Shreen Lashien
Dec 15, 2024
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Shreen Lashien, a PhD candidate in Orthopedic Physical Therapy at Cairo University, dives deep into the world of shin splints—an overuse injury affecting runners. She explains the causes and explains the diagnostic differences from stress fractures and compartment syndrome. Shreen shares evidence-based treatment protocols, emphasizing the importance of rest and rehabilitation. She also highlights effective preventative measures, including strengthening hip muscles and proper running mechanics, to help runners stay injury-free.
Shin splints are primarily caused by overuse and improper biomechanics, leading to inflammation and microdamage in the tibia.
Effective prevention involves choosing suitable running surfaces and footwear, while focusing on strength training for hip abductors.
Deep dives
Understanding Shin Splints
Shin splints, also known as medial tibial stress syndrome, is primarily caused by overuse and excessive impact during running. This condition arises due to two competing theories regarding its pathology: one suggests inflammation of the periosteum—the outer layer of the bone—caused by traction from the calf muscles, while the other posits that stress distribution on the bone leads to microdamage. Runners often experience diffuse pain along the medial border of the tibia, particularly in its distal third. Proper diagnosis is crucial, as untreated shin splints can progress to more serious injuries like stress fractures.
Key Risk Factors and Symptoms
Several factors contribute to the development of shin splints, including hip abductor weakness and poor biomechanics, which can lead to a cascade of compensatory movements throughout the lower limb. Symptoms typically intensify during running and diminish with rest, making it essential for runners to differentiate shin splints from other conditions such as stress fractures and compartment syndrome. Using functional tests, such as the single-leg hop, can help distinguish between these injuries, as those with stress fractures will experience significant pain. Effective treatment protocols emphasize the importance of recognizing these symptoms to address the condition before it escalates.
Rehabilitation and Strengthening Exercises
Rehabilitation of shin splints primarily involves a combination of rest, anti-inflammatory measures, and a gradual return to activity based on the severity of the condition. Key strengthening exercises should focus on the hip abductors to improve lower limb mechanics, such as lateral step-ups and single-leg bridges, which help create a balanced force distribution during running. Additionally, stretching routines, particularly for the calf muscles, should accompany strengthening to alleviate tightness that may contribute to this condition. Progressing exercises from basic movements to more complex tasks, while monitoring symptoms, is crucial for effective recovery.
Preventative Measures for Runners
To prevent shin splints, runners should adopt a comprehensive approach that includes the choice of running surfaces, appropriate footwear, and a solid training plan. Running on softer surfaces, like grass or synthetic tracks, can significantly reduce impact stress on the shins. Furthermore, selecting the right shoes, such as those with proper arch support or shock absorption, is vital to accommodate personal foot mechanics. Consistent strength training, particularly for hip abductors, coupled with gradual mileage increases, forms the foundation of an effective injury prevention strategy.
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Guest: Shreen Lasheen, PhD Candidate in Orthopedic Physical Therapy, Cairo University
Episode Summary: In this insightful episode, we sit down with Shreen Lasheen, a leading researcher specializing in running-related injuries, particularly shin splints (medial tibial stress syndrome). With years of clinical and research experience, Shreen shares her deep understanding of shin splints, how they develop, and evidence-based strategies for treatment and prevention. Runners at all levels will gain valuable tips to stay injury-free and optimize their performance.
Key Topics Discussed:
1. Understanding Shin Splints
Definition & Causes: An overuse injury due to excessive ground reaction forces causing inflammation of the tibia’s periosteum or bone microdamage.
Pathology Theories: Traction from the calf muscles and direct bone overload.
2. Diagnosis & Symptoms
How to Differentiate Shin Splints from Other Injuries:
Stress Fracture Test: One-leg hop test (unable to hop = potential stress fracture).
Compartment Syndrome Signs: Numbness, tingling, and pale skin.
Key Symptoms: Diffuse pain along the inner shin, worsening with activity and improving with rest.
3. Treatment and Rehabilitation
Rest and Recovery: Following MRI grading-based rest periods (2-9+ weeks).
Rehabilitation Exercises:
Strength Training: Hip abductor exercises such as pelvic drops, side-lying hip abductions, and single-leg bridges.
Flexibility Work: Calf stretches and ankle dorsiflexion exercises.
Balance Exercises: Progressing from two-leg to single-leg stability tasks.
Supportive Therapies: Ice application, kinesio taping, and potential use of orthotic insoles.
4. Prevention Tips for Runners
Training Adjustments: Run on softer surfaces (grass, sand, synthetic tracks) for most runs; limit road running.
Footwear Selection: Use appropriate shoes based on individual foot mechanics (shock-absorbing or pronation control insoles).
Gradual Progression: Increase mileage gradually to allow for musculoskeletal adaptation.
What Recreational Runners Will Learn:
How to recognize the early signs of shin splints.
Evidence-based treatment options to speed recovery.
Strength and mobility exercises to reduce injury risk.
Best practices for shoe selection and surface adaptation.
The importance of balancing training loads to stay injury-free.