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| Tibialis anterior and posterior muscles function to stabilize the foot and arch in gait, and help to absorb shock and control pronatory motion of the lower ankle (subtalar) joint. |
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The term "shin splints" is a catch-all description
of shin pain which can be from many causes. The most common
causes include:
- Strained or over-worked muscles in the leg.
- Bone which may be bruised, inflamed or have a stress
fracture.
- Compartment syndrome
The muscles that cause shin pain most commonly are the
Tibialis anterior and posterior. Both of these muscles
function to stabilize the foot and arch in gait, and help to
absorb shock and control pronatory motion of the lower ankle (subtalar) joint. These muscles are
in the front (anterior) and back (posterior) of the leg and
have tendons that insert into the foot. When these muscles
are over-worked or strained, shin pain may develop. Depending
on the severity of injury, pain can occur with or without
activity. Pain can be in the muscle belly or the muscle
attachment on the bone or in the tendon.
Activities which involve running or high impact are common
causes of injury. This is because with running, 3 to 4 times
ones body weight goes through the foot and leg with each
stride, and the muscles are unable to meet these demands. If
you have this injury, first rest and ice daily until you are
pain free. Then, to avoid re-injury build up your athletic
activity gradually by working out initially every other day,
and not increasing the duration or intensity of the activity
more than 10% per week. For some, it may be necessary to do
exercises such as toe lifts with low resistance for the
Tibialis anterior, or independent (one leg at a time) heel
raises for the Tibialis Posterior. Three sets of 30
repetitions is advised, in order to build endurance. This
regimen allows the body to adapt to the increasing stress,
avoiding injury. Proper equipment needs to be used as well,
and shoe gear needs to be inspected for excessive wear. Shoes
must have firm midsoles that provide heel support, and are
not broken-down which allow the heel to turn in. The surface
one runs on is also important. If possible, run over soft
rolling terrain, avoiding steep hills and cement. Despite
following sensible training, some athletes have abnormal
biomechanics of the feet and need the additional support orthotics provide.
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