Shin splint basics for the general crossfitter
A traditional “Shin splint” is commonly known in the medical community as “medial tibial stress syndrome” or MTSS. There is also “anterior shin splints/anterior compartment syndrome”. That nagging, hot pain on the front of the shin just OUTSIDE or lateral to the tibia (the shin bone) is usually considered Anterior Shin Splints. Just Inside or medial to the tibia is MTSS. It is thought that inflammation and tendonitis develops between the muscular attachments, the fascial connections, and the tibia bone. This can be mild, moderate, or severe, as is the case with tibial stress fractures and compartment syndrome.
Medial tibial stress syndrome is usually located on the medial aspect, about 3-12cm above the ankle bone (medial malleolus). It is thought that eccentric loading of the soleus, flexor hallicus longus, and flexor digitorum longus causes increased strain at the attachment sites along the tibia and fascial connections. This eccentric loading is pronounced for people with over pronation, therefore, controlling pronation is a common recommendation for treatment.
Anterior shin splints are usually 5 to 8 centimeters long and about 1 to 2 centimeters wide on the lateral side of the tibia. Certain crossfit activities including, broad jumping, box jumping, jump-rope and running up inclines, require excessive dorsiflexion of the ankle to clear the toe from the ground. The most commonly thought process with anterior shin splints is a lack of extensibility of the posterior ankle. This makes the anterior muscles have to work much harder to dorsiflex the ankle and overcome the tightness of the posterior muscles, such as the gastrocnemius and the soleus muscles.
Shin splints are also associated with bone stress fractures of the tibia. Most injuries that clinically seem to be stress fractures have what is called a region of pinpoint tenderness and extend in a horizontal direction versus up the shin. Your MD may choose an xray or bone scan if they feel your severe shin splints could be a stress fracture.
Shin splints has been associated with :
A traditional “Shin splint” is commonly known in the medical community as “medial tibial stress syndrome” or MTSS. There is also “anterior shin splints/anterior compartment syndrome”. That nagging, hot pain on the front of the shin just OUTSIDE or lateral to the tibia (the shin bone) is usually considered Anterior Shin Splints. Just Inside or medial to the tibia is MTSS. It is thought that inflammation and tendonitis develops between the muscular attachments, the fascial connections, and the tibia bone. This can be mild, moderate, or severe, as is the case with tibial stress fractures and compartment syndrome.
Medial tibial stress syndrome is usually located on the medial aspect, about 3-12cm above the ankle bone (medial malleolus). It is thought that eccentric loading of the soleus, flexor hallicus longus, and flexor digitorum longus causes increased strain at the attachment sites along the tibia and fascial connections. This eccentric loading is pronounced for people with over pronation, therefore, controlling pronation is a common recommendation for treatment.
Anterior shin splints are usually 5 to 8 centimeters long and about 1 to 2 centimeters wide on the lateral side of the tibia. Certain crossfit activities including, broad jumping, box jumping, jump-rope and running up inclines, require excessive dorsiflexion of the ankle to clear the toe from the ground. The most commonly thought process with anterior shin splints is a lack of extensibility of the posterior ankle. This makes the anterior muscles have to work much harder to dorsiflex the ankle and overcome the tightness of the posterior muscles, such as the gastrocnemius and the soleus muscles.
Shin splints are also associated with bone stress fractures of the tibia. Most injuries that clinically seem to be stress fractures have what is called a region of pinpoint tenderness and extend in a horizontal direction versus up the shin. Your MD may choose an xray or bone scan if they feel your severe shin splints could be a stress fracture.
Shin splints has been associated with :
- Over-pronation (associated more with MTSS)
- Muscular tightness of the Gastrocnemius and Soleus musculature.
- Running on concrete
- Running on cantilevered surfaces
- Training too hard/too fast
- Running on inclines
- Inappropriate shoe-ware. I would interpret this as worn out shoes, or lack of arch support when it is needed in a certain individual’s shoe, since nowhere could I find what was deemed “appropriate” for shin splints in general.
- muscular imbalance. This could be between the inverters and everters or the dorsiflexors and planatrflexors. Hip abduction weakness can also lead to overpronation during running, resulting in shin splints.
- Calcium deficiency has been correlated with shin splints
Treatment/prevention
If you find yourself a victim of this very painful condition you can try the following things...
1. Evaluate your training. Have your WODS included a significant increase in running or jumping patterns? If so, scale back.
2. Evaluate your training. Have you been running on concrete, curved surface or inclines recently? Vary your running surfaces as much as you vary your WODS. Grass/packed dirt/rubber track etc. Try running your routes the opposite direction.
3. Evaluate your mechanics while training. Take-off and landing mechanics for jumps are as important as running technique in crossfit. Are your heels on the box when you land? (they should be) Do your feet and knees cave in during your landing or takeoff? (they shouldn’t be). Even a subtle mechanical error multiplied by hundreds of reps can lead to injury very quickly.
http://michaelreid.typepad.com/michaelreid/2007/10/girls-and-knees.html
4.
Evaluate your feet. Are you a hard pronator? If so, you may
benefit from some arch support, even if it is the use of kinesiotape,
athletic tape, inserts, or an athletic shoe designed for pronators (barefoot running is not for everyone unfortunately). There are also great exercises you can perform to help address overpronation.
.
http://www.bostonrunningcompany.com/gaitanalysis.html
http://www.harmonypt.com/treatment/kinesio_taping/
5. ICE cupping! Ice the area of pain 1-3x a day with the ice cup method. Fill a small paper cup about two-thirds full, and freeze it until it is solid. Peel off the top of the cup so about 0.5 in. of ice is
showing. The remaining part of the cup is for you to hold on to. Massage the area in small circular motions for 8 minutes, or until you can no longer feel the ice.
6. Self myofasical release. Make an effort to regularly foam roll your lower leg several time a week. One of the best resources I would recommend in Kstar at Mobilitywod.com. Here is one of his posts specific to shin splints:
6. Self myofasical release. Make an effort to regularly foam roll your lower leg several time a week. One of the best resources I would recommend in Kstar at Mobilitywod.com. Here is one of his posts specific to shin splints:
7. Strengthen the inverters and everters of the ankle. Strengthen the hip abductors. Google it. :)
8. Stretching and mobility word to increase dorsiflexion ROM. 3x a day for at least 30 secs although I recommend 2 mins for each stretch. Also involve the big toe, by gently stretching it up into dorsiflexion. Check out prostretchers for a nifty tool to help with this. We have one! Have you seen it? Can you find it? Hint: It's blue.
9. Most important!!! (I always think of this as common sense, but alas, it is not) If it hurts, DO NOT DO IT! You know that "injury" hurt and "intensity" hurt FEELS quite different. If your body is telling you that you are irritating an injury. YOU ARE. It will be more difficult and take longer to recover from an injury you do not honor. REST.
OK but what about the shoe? which one best for me from hete? running shoes for shin splints
ReplyDelete