Most shin pain is the result of repetitive overuse that ends up overloading the structures such as your bone, muscle and tendons. Your calf muscles protect your shin bone from the back, however excessive load through your shin bone (tibia) will cause shin pain and numerous other injuries.
To establish where exactly the shin pain is, can be very helpful at identifying what structure is causing the pain. Shin pain can be caused by any of the muscles, tendons or joints, so let’s look at the different types of structures in the thigh:
Pain in the shin is usually gradual onset and can be difficult to get rid of. Shin splints is known as pain on the inside of the shin but is not a diagnosis in itself but a description of symptoms.
The major muscle group on the inside of the shin is the Calf muscles, Gastrocnemius muscle attaches to the top third and the Soleus muscle the middle to lower third. The Flexor muscle group also sits on the inside of the shin (Flexor Digitorum Longus, Brevis and Flexor hallucis longus) and runs along the inside of the lower leg, where their tendons run behind the knob (Medial Maleolus). Theses muscles point your toes and keeps the arch of your foot up.
Muscle strains are often called ‘muscle pulls’ or ‘pulled muscles’ because of the way these injuries occur, the muscle tissue is forced to stretch beyond its normal limits, and tears. Depending on the number of muscle fibers that are torn, calf muscle strains are classified as first degree (least severe), second degree (moderate severity) and third degree (most severe) strains.
Nerve supply to the shin comes from two big branches called the femoral nerve in the front and the sciatic nerve at the back. Irritation, compression or impingement of these nerves can cause nerve pain in the shin.
Sciatica is also a condition that can cause shin pain from the thigh, over your knee and all the way to your toes. Your femoral nerve can also cause nerve pain to the front and top of your knee.
Tendons are cables that anchors the bone to muscle tot the bone. Every muscle has a tendon on either side of the muscle, the one at at the top called the proximal tendon and one at the bottom, called the distal tendon. Any one or multiple tendons can become irritated.
Joints can refer pain downwards from the knee, or upwards from the ankle joint. Joint pain is usually more difficult to pinpoint therefore a skilled set of hands would need to determine where the pain is coming from.
Shin pain is extremely common therefore we have helped many patient relieve their pain. Most shin pain don’t start after a fall or injury, but usually develops over time, but it can occur as a result of sports injuries, work injuries or simply everyday leg use.
If you are suffering from shin pain, rather get it checked. Please do not delay in consulting your physiotherapist if you have shin pain. Rather do something about it and get it looked at, than wait with your fingers crossed and hope it goes away.
An accurate diagnosis is vital to manage your pain and treat it appropriately, because what works for one problem rarely works for another. Many conditions can take many months or even years to heal when the diagnosis is incorrect or treatment is neglected.
Vastus Lateralis muscle tear or strain
ITB syndrome (Iliotibial band syndrome)
Bursitis of the Bursa deep to the Iliotibial band
Tensor Facsia Latae muscle strain
Inside the joint
Knee joint pathologies
Hip joint pathologies
Causes of Shin pain
Most causes of shin pain in athletes are from bone stress, insufficient blood flow, tendon inflammation, compartment syndrome or nerve entrapment. The structures in the thigh is vulnerable to injury especially overuse injuries i.e. repetitive movements like a walking, climbing stairs and running.
Shin pain may be caused by:
- Repetitive overload – Bone stress fractures (Medial Tibial Traction Syndrome)
- Overload – Muscle or ligament strains and sprains.
- Trauma – Contusions, fractures
- Overuse – Tendon inflammation
- Instability – Poor ankle stability (over-pronation of the ankle joint)
- Autoimmune – Rheumatoid arthritis
- Referral from other joints – Knee or ankle joint
- Referral from nerves – Irritation, compression of the femoral or sciatic nerves.
Shin Pain Treatment
- Acupuncture & Dry Needling
- Heat packs (Thermal therapy)
- Kinesiology Tape
- Rigid Strapping or taping
- Neurodynamics (Nerve tissue mobilizations)
- Dynamic Strapping
- Strengthening exercises
- Guided loading protocol
- Stretches (Static, dynamic and ballistic)
- Moon boot
- Compression Bandage or Sleeve
- Supportive strapping and taping
- Biomechanical Analysis
- Gait Analysis