Host: Dr. Matt Minard
Dr. Matt Minard, the owner of Learn 2 Run, is a Physical Therapist who enjoys both the physical and mental benefits of running. He is passionate about helping others run safely.
In this episode, Dr. Minard discusses shin splints, highlighting the causes and major considerations for effective management tailored towards self-dependence.
- “There is a limitation in the amount of stress or force that you can take before breakdown, aka injury”
– [Dr. Matt Minard]
- “Your body has an amazing capacity to heal; it just has to be in the right environment”
– [Dr. Matt Minard]
- “All injuries are temporary, it’s a matter of when not if”
– [Dr. Matt Minard]
- [01:31] What are “shin splints”?
- [12:23] Describing shin splints with sunburns.
- [17:05] How can we create an optimal environment for tissues to heal?
- [18:27] Identifying and addressing the causes of shin splints
- [32:48] Considerations for clinicians in managing shin splints.
- [37:31] What should you look out for with shin splints?
To decide today’s topic, listeners voted on Instagram. The topic selected by the majority of listeners was shin splints.
What are shin splints?
Shin splints refer to bone bruises. A bone bruise is a type of traumatic injury that is less severe than a bone fracture. Just like the bruise from the trauma of a kick to the shin, running can also cause a bone bruise. With each step that hits the ground, there is an equal but opposite reaction. The direction of the force of this reaction is towards the shin repetitively. This repetitive force mimics thousands of tiny kicks and may become an overuse injury. People with shin splints often perform repetitive activities.
What causes shin splints?
Another name for shin splints is medial tibial stress syndrome. The stress here is physical stress (i.e. load or force which is a product of gravity and physics). Unlike lying down, putting your foot on the ground transfers load to the arch of your foot. This load or force varies in size, speed, and frequency.
These factors matter because there is a limit to how much load or force you can take before an injury occurs. Fortunately, the body can heal from any injury.
Shin splints are like sunburns. Just as sunburns are caused by excessive exposure to sunlight in a short time, shin splints are bone bruises caused by excessive load or force. Reducing exposure to sunlight helps the body recover from sunburn. In the same way, reducing the load on the shin aids the healing of the bone. We cannot speed up healing but we can slow it down if we identify and address the cause.
When dealing with Shin Splints ask yourself, “Is there anything new or more that I’m doing?” Next ask, “what is negotiable and what is not?” To identify the cause of shin pain, look out for anything new or increased activity. For example, a new physical activity picked up.
These questions can help decide on areas where changes can be implemented. Additionally, consider setting dates and timelines where you carry out other activities to achieve fitness goals without putting the load on the shin. Off days for recovery are very important, this is the time to heal. Your body is strong and will heal, you just need to create an environment to allow yourself to heal.
Below are a few common scenarios where shin splints may occur.
Consider the case of Pandy Andy, a plus-sized man who took up running to lose weight. This put an increased amount of load on the knee and affected the shin, particularly because of bounding.
In this situation, it would help to reduce the time spent running. At first, alternate with periods of walking. Then in small incremental amounts, add to the running.
A tool to monitor bounding is the tennis ball necklace which Dr. Minard describes how to make in the video below. Using this, you can observe when you’re bounding as the ball bounces. The goal is to reduce the ball movement as much as possible.
Another case is that of a super mom. She is very active physically and has just gotten new wood floors. Wood floors increase the susceptibility to load which is worse when combined with walking barefooted.
It would help to have soft mats around those areas of the house where she stands most often.
It was also noted that this mom recently returned to work where she wears heels. When she comes home no her lunch break, she wears those heels to walk her dog.
Having a walking shoe with a soft padded sole for walking the dog would be another solution. It is important to identify the things that stress the bone and those that heal it; when we are not stressing the bone, it’s healing.
3 Sport Tommy
Another case is an 8-year-old kid who loves sports. One of the factors responsible for his shin splint was a very heavy book bag which increased the load on the bone.
Reducing that load was the first step.
Second, he started playing a new game at recess, hopscotch. If you aren’t familiar, hopscotch involves a lot of jumping on cement.
Occasionally replacing the game with others or changing worn shoes would also be helpful.
What should clinicians know about shin splints?
Clinicians need to keep in mind that strengthening or lengthening as an approach to shin splints may increase the load or force, rather than allowing the shin to heal. In cases where the cause is hip abduction weakness, loading strategies or stretching should be modified to reduce the stress on the shin.
While physical therapy plays a role in treating shin splints, creating a promising environment that encourages healing is critical. Generally, efforts should be directed at building independence for the patient to address and prevent the cause of the shin splints, rather than depending on the clinician solely.
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