Posterior shin splints usually present with a few key symptoms, including a twinge on the inside of the shin bone with every walking step, an unbearably sharp pain with every running stride, and a feeling of hopelessness about ever returning to normal. What starts as some slight discomfort can quickly become debilitating pain for even the toughest of athletes. The journey to pain relief begins with comprehension of the underlying causes of injury.
The Posterior Tibialis and Shin Splints
Posterior shin splints are named thus because they are the result of damage to the posterior tibialis. The injury is frequently called medial tibial stress syndrome because the posterior tibialis runs along the medial and posterior aspect of the tibia, and later progressions of the injury can cause damage to this area of the bone. The posterior tibialis is located in the deep posterior compartment of the lower leg. It originates along the tibia and fibula, with the tendon running behind the medial malleolus and attaching on several points on the underside of the foot. This muscle is a key stabilizer, and also acts to extend and invert the ankle.
Fallen Arches, Pronation, and Shin Splints
Because of its positioning, the posterior tibialis affects and is affected by the arch of the foot. In people with collapsing arches or flat feet, the posterior tibialis is forced to stretch over a longer distance than normal. This is particularly significant for athletes who run or otherwise load their feet, as the arches compress further with each stride or leg-loading movement. As a result, the posterior tibial tendon receives strong, repetitive pulls while in an already stretched position, causing microscopic tears in the muscle and the connective tissue that connects the muscle to the tibia.
Pronation of the ankle causes the same problem as flat feet, an unsurprising fact since the two issues are often closely related. Excessive pronation is seen most often in runners. Their ankles roll inward with each stride, effectively flattening their feet and causing an inordinately forceful pull on the posterior tibial tendon. In effect, a very minor movement pattern defect can lead to significant damage and excruciating pain.
Treating Posterior Tibialis Shin Splints
Treating posterior shin splints involves two main steps. The first is treating the symptoms of overuse with a few key treatment modalities. Once the pain and damage are under control, the second phase of treatment can begin. This phase revolves around rehabilitation, with an emphasis on developing strength and proper movement. Strength in the posterior tibialis helps prevent pronation and lifts the arch. Strengthening the muscles of the feet can also help support an overstretched plantar fascia, reducing the effects of flat feet. Finally, a focus on certain motor recruitment patterns can prevent the recurrence of this irritating variety of shin splints.
Sources:
WebMD.com, "Shin Splints (Tibial Stress Syndrome)," (accessed April 24, 2011).
Omid Adibnazari - Omid Adib is a student-athlete with years of experience in fitness training. He has earned a bachelor’s degree in biology and is ...
Join the Conversation