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Remedial Massage : Shin Splints

Shin splints can encompass a number of different pathologies, including periostitis, muscle strain, stress fracture, and compartment syndrome.  In most cases the term applies to periostitis and muscle irritation resulting from overuse.  Pain can occur in the anterolateral region of the tibia or the medial and distal tibial region.  Medial shin splints is also called Medial Tibial Stress Syndrome (MTSS) and the primary muscle involved is tibialis posterior.  Soleus is also a causative factor in MTSS.

The tibialis posterior works eccentrically during normal gait mechanics to prevent overpronation.  Foot overpronation places excessive loads on the tibialis posterior, and tensile stress is concentrated at its attachment site on the tibia.  Studies have shown that a forefoot running stride puts excessive tensile stress on the tibialis posterior muscle and when the running stride was corrected the shin pain was relieved.

MTSS can be a precursor to stress fractures in the tibia, therefore a stress fracture should always be considered as a possible cause of pain.

Traditional approaches:

Rest from offending activities, orthotics to correct bio-mechanical distortions in the gait pattern, ice applications after activity, anti-inflammatory medication and massage is highly effective in this condition's management.  Stretching is an important component of treatment for shin splints and strengthening and conditioning of the region can commence once the condition's symptoms have substantially reduced.

Treatment techniques for MTSS:

Deep stripping with active engagement lengthening movements and active engagement with resistance.  This technique can be painful so stripping should be applied within pain tolerance of the patient.

 

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