Posterior Muscular Shin Splints


Muscular shin splints anatomy & symptoms

Inflammation of the muscle attachments and interosseous  membranes to the tibia (shin bone) on the inside of the front of the lower leg. The most common form are posterior shin splints affecting the inner part of the lower leg at the insertion of a major decelerator muscle of the foot, namely tibialis posterior. Pain is felt on palpation (touching) or when walking/running approximately half way up the inner shin. Pain is only felt in the the muscular region right next to the tibia (shin bone) and not when touching the bone itself.

Tibialis anterior
Most textbooks only describe the above problem but podiatric practitioners dealing with lower limb musculo skeletal disorders regularly come across patients with similar symptoms but affecting the outside part of the lower leg. These are known as anterior shin splints and are almost as common as the posterior shin splints. These are caused by inflammation of the insertion of the  second decelerator of the foot, namely tibialis anterior. Like posterior shin splints pain is felt on palpation (touching) and when walking/running but crucially pain is felt on the other side of the shin bone (on the outer part of the leg). Again pain will not be felt when touching the bone itself

Pain is most severe at the start of a run, but may disappear during a run, as the muscles loosen up. This is different to a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)

Beginner runners are more susceptible to this problem for a variety of reasons, but most commonly due to the fact that the leg muscles have not been stressed in such a way before they started running.

Shin splints are almost always caused by improper biomechanics made worse in runners due to the excessive biomechanical forces placed on the major decelerator muscles (tibialis anterior and tibialis posterior) in the lower leg. These muscles effectively slow the foot down during the contact phase of gait (when the foot hits the ground). Athletes who have compensatory pronatory forces affecting their mechanics during this phase are most susceptible to this form of injury.

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REST! I know that’s a bitter pill to swallow for all sportsmen and women but resting in the initial stages is imperative to prevent further damage. Do not attempt to do any sports that cause the shins to hurt until the pain has gone completely  If you want to keep exercising, try swimming or another low-impact activity. You may want to try working out on non-impact elliptical trainers (cross trainers) which will give you exactly the same cardio work out as running but without the impact forces. Because these machines support your body weight, they put less stress on your lower legs. when your shins feel better.




Remember that virtually all soft tissue shin splints occur at contact phase of gait (when the foot hits the ground) due to increased biomechanical stress at this point. No amount of exercising will influence what happens at the point of heel strike, mid-stance and toe off phases of gait. It is therefore vital to improve your biomechanics with orthotics designed for your chosen sport.

Golden rule- Don’t ignore the problem, it won’t go away! If you have been afflicted by this injury it is virtually certain that you will have another attack sooner rather than later.

The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family). The way you function is set and cannot be cured. What you can do however is control lower limb biomechanics by altering foot position during the contact phase of gait. This can only be done by wearing a good shoe (see our shoe guide) and with orthotics  (foot beds).

This is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and from helping to prevent re-injury. Overall costs for the average athlete will run into pennies per mile/hour of sport. Orthotics are designed to alter the biomechanics during the time the foot is on the ground. They are also used to provide increased shock absorbency working in harmony with the sport shoe worn.

Think you require treatment for your biomechanical problems?

Visit our Sports podiatry clinic directory pages for a clinic near you.

returning to sport after muscular shin splints

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your knee recovers, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

You have full range of motion in the injured leg compared to the uninjured leg.

You have full strength of the injured leg compared to the uninjured leg.

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can do 45-degree cuts, first at half-speed, then at full-speed.

You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.

You can do 90-degree cuts, first at half-speed, then at full-speed.

You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.

You can jump on both legs without pain and you can jump on the injured leg without pain.