How To Use The Foam Roller For Shin Splints

Introduction

If you run or train regularly there is a huge chance that you have encountered the dreaded curse of shin splints! Furthermore, if you are a trainer or health professional, then I am sure you have seen many clients present with this condition. There is good reason for this – it is very common and often poorly managed! Published studies have shown that shin splints account for 6 –16% of injuries among runners, and is often the most common injury amongst this group and other sports including ballet (Thacker et al., 2002). Given the frequency with which this condition presents, there is a huge demand of quality information regarding its management. Therefore,  this post will discuss shin splints including some background on the condition, the relevant anatomy and of course the most appropriate rehabilitation exercises.

So, What Are Shin Splints?

Well, that is a controversial question! The blanket term of ‘shin splints’ often covers many conditions, and means different things depending on who you ask. In the science world ‘shin splints’ may mean any of the following conditions (some will have to excuse the technical terms):

  • Tibial stress reaction
  • Periostitis
  • Enthesis
  • Fibrositis
  • Myositis
  • Traction periostitis or periostalgia
  • Interosseous membrane pain
  • Bone strains
  • Tenosynovitis
  • Tendonitis of the tibialis anterior, the tibialis posterior, soleus, or the flexor hallucis longus muscles
  • Microfracture
  • Chronic tendonitis
  • Fatigue tears of collagen fibers that bridge the connection of muscle fibers to bone
  • Chronic compartment syndrome

Wow!! No wonder people are confused on how to treat this thing!

Most commonly, we see ‘shin splints’ that affect the inside or medial part of the shin bone and this is classified as ‘Medial Tibial Stress Syndrome‘.

Enough of the jargon, give it to me straight! 

Ok, in simplistic terms we see the fascia (soft tissue) that connects the muscles of the lower leg (think calf area) to the shin bone (tibia) becomes irritated or inflamed because of too much loading. This is often as a result of high impact loading (think pounding the pavement) and fatigue of the lower leg muscles – which causes them to become too tight and put strain through this area. The result – pain and irritation/inflammation along the inside shin bone with activity! (Simple enough, or did I just send you cross-eyed?).

As previously mentioned this condition is tough to treat (excuse the understatement). You know what they say, prevention is the best cure!

What Are The Risk Factors for Developing Shin Splints?

There are many risk factors for the development of shin splints, many of which have been proven in scientific research and some anecdotal from sports medicine professionals (Thacker et al., 2002; Tweed et al., 2008). Such risk factors include

  • Lack of running experience
  • Competitive running
  • Excessive weekly running distances
  • Previous injury – this is a big one!
  • Female gender … sorry ladies.
  • Flat feet (known as excess pronation)
  • Hard running surface
  • Use of worn or inadequate shoes
  • Reduced flexibility of the calf muscles/lower leg muscles
  • Reduced strength/control of extrinsic foot muscles (these include tibialis posterior, soleus, and flexor hallucis longus

Anatomy and Muscular Contributions to Shin Splints

There are quite a few lower leg muscles that are often considered to be involved in development of shin splints and medial tibial stress syndrome. This includes tightness/reduced flexibility in the:

  • Calf muscles (gastrocnemius and soleus)
  • Tibialis Anterior
  • Tibialis Posterior
  • Flexor Hallucis Longus

Muscles Of The Lower Leg

As well as tightnesses, shin splints is also characterised by reduced strength and control in a number of the lower leg muscles. These include:

    • Tibialis Posterior
    • Flexor Hallucis Longus
    • Soleus
    • Intrinsic Foot Muscles (the muscles that support the arch of the foot)
Tibialis posterior

Anatomy

So, what can be done about this condition?

Foam Roller Exercises for Shin Splints

The most appropriate exercises are those that target the myofascial structures of the:

      1. Gastrocnemius and Soleus (Calf Muscles)
      2. Tibialis Posterior (and other deep muscles on the inside of the leg, including flexor hallucis longus)
      3. Tibialis Anterior

The videos below displays all of these components:

Calves and Tibialis Anterior

Medial Calf and Tibialis Posterior

What Size Will Be Most Useful?

Given that you are going to cover a medium sized area i.e. the length of your calf, the best foam rollers for this condition would be:

Should I Do Anything Else?

Yes! Unfortunately, the foam roller is only one component of the successful rehabilitation of shin splints. To fully resolve this complex problem you should also undertake:

      • Regular Calf Stretching (Gastrocnemius and Soleus)
      • Regular Lower leg strengthening exercises – particularly tibialis posterior, gastroc-soleus, intrinsic foot muscle strengthening
      • Appropriate load management i.e. get enough rest and do not do too much too quickly!
      • A footwear revision – to ensure you have enough support and cushion
      • Be guided by your physiotherapist – who can take you through all of this including a full biomechanical assessment

References

Thacker SB, Gilchrist J, Stroup DF, Kimsey CD. The prevention of shin splints in sports: a systematic review of literature. Med. Sci. Sports Exerc. 2002;34(1):32-40

Tweed JL, Avil SJ, Campbell JA, Barnes MR. Etiologic factors in the development of medial tibial stress syndrome A review of the literature. J Am Podiatr Med Assoc 2008;98(2): 107-111

Photo Credit: WikiCommons

 

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