Don Hazen

Shin splints are the result of an inflammation of the periosteum of the Tibia. The periosteum is the fascial sheath which covers the bone and into which tendons insert. Running on hard surfaces (the first week of winter track season used to do it) and/ or excessive pronation place strain on the periosteum, causing it to disengage (micro tearing) from the bone.

The inflammatory process causes pain and reflexive muscle spasm. You can have client ice, if they’ve been working out to cause the problem. Working the spasmed muscles will give relief. Check the orientation of the foot in standing and walking, and if possible in running, for excessive pronation.

Mild shin splints are generally self-limiting, which is medicalese for “they heal by themselves.” The client may have to reduce their activity to allow healing to take place and begin again more gradually.

Joe Breck

Another functional issue with shin splints seems to be that runners have a particularly jarring heel strike. They also frequently seem to run with legs in front of their body, as if they were pulling themselves forward. Even in walking, these people’s torsos are back behind their legs; they use Tibialis Anterior and seem to grip the ground with their toes and pull themselves forward. Thus, they build up extra connective tissue around the Tibia.

Allan Kaplan

I think Don’s assessment of the periosteum and shin splints is a point that must not be overlooked. I think that all too often relief gotten by simply attending to the more superficial or readily available aspects of the sheath can be temporary because the periosteal aspects have been (inadvertently) ignored. Sort of akin to the phenomenon of a lateral release working for a while, and then not giving relief. I’d say that attending to the entirety of the bag is essential, while working solely on that part on the surface will help.

Diane Rodgers

Also look at possible Tibialis Anterior/ Gastrocnemius and Soleus muscular imbalance, which often is the cause of the periosteal tears; and check in with the arches. Also, some of us need to run on more forgiving surfaces than pavement.

Bill Morrow

Another thing you may want to look at is whether the person is primarily using their lower legs to move them when they run. I find that when runners get tight in the pelvis that they will compensate by over-using the lower leg and feet. You may want to look at hip joint mobility as well, to help reduce strain.

Greg Knight

I find that the superficial fascial wrapping around the lower leg, ankle and foot are very unforgiving, stiff, tight, and feel as though they are one size too small for the leg they are on. Anything from the knee down, especially around the tuberosity of the Tibia, its anterior border and the retinacula of the ankle – all the way around – need to be freed. As I find the way the tissue won’t go, I lengthen it – “take the tissue where you want it to go…” – and have the client move, usually dorsiflexing their fool or rotating their leg – ” … and ask for movement.”

It feels good just thinking about it.

As Don eloquently pointed out, because “shin splints are the result of an inflammation of the periosteum of the Tibia” and “the periosteum is the fascial sheath which covers the bone and into which tendons insert,” easing these large superficial fascial sheaths does wonders without poking around a lot It gives room for the individual muscles to move more easily, without such a tight, ischemic sock squeezing them.

Also, I’d check the subtalar joint. If you know how to feel and assess the Navicular and Cuboid, you might find that they don’t move properly in one or more planes. I believe that when these joints can’t move through their complete ROM to normal end-feel, that the load of walking and running can be inappropriately spread into the more superior structures like the Tibia.

Cindy Jamieson

Beyond all the fabulous information on shin splints, remember the mechanical issue of shoes and ski boots. Typically, running shoes are only good for about three to four months. They still look great, so people think they are working. The same goes for X / C ski boots. Both break down and are no longer supportive.

Jeremy Sutton

I have noticed that the posterior deep and superficial compartments of the lower leg seem to become one compartment with no individual movement. Also, it seems that the glide of the Tibia on the Talus is limited or actually too great. Shin splints are a perplexing problem to which nobody really has an answer.