Re: Re: Shin Splints

[Guest guest]

From my experiences with high school runners, I believe there are four

reasons why these types of athletes develop foreleg pain, or what as a catchall

term we often call a shin splint. They get a sprain or rip to the posterior

tibial muscle. This seems to be the most common cause of shin splint pain

(probably around 75%). Athletes sometimes develop inflammations of the bone

covering of the lower leg bone. This is called tibial periostitis. I don't see

this that often in my runners. The third is anterior compartment syndrome--an

interruption of the blood supply to the three muscles of the front of the

lower leg. Compartment syndrome is what I often suspect when the athlete isn't

responding to conventional treatment. However, the orthopedic guys I've

consulted, though not ruling it out, have been reluctant to consider

fasciotomy an option in the absence of a confirming pressure test. I have never

had an

athlete whose test results indicated elevated pressure in any of the

compartments. The fourth is a tibial stress fracture, which at first is often

thought to be a shin splint. The diagnosis of a stress fracture, usually

confirmed

by a bone scan, is the real heartbreak for high school kids.

I have used all the recommended modalities, including Bob Gajda's D.A.R.D.

(dynamic axial resistance device) which has been part of our rehab/conditioning

regime since 1982. Incidentally, I have one of the original editions of

Bob's book, Total Body Training, which he autographed for me (to his Polish

brother) when we had pizza together a few years ago.

I have not had the level of success that others have using the recommended

strength gain or stretching protocols, but I continue to use them. I've often

suspected that there may be something else going on in these difficult cases

other than a muscle imbalance or a reaction to changes in training. I

recently contacted Hoddle, Tony Volpentest's former coach, to confirm

that

Tony did indeed suffer shin splints--interesting in that, as I had previously

noted, Tony did not have feet. This would raise some questions regarding

posterior tib problems and excessive pronation. did point out that

Tony's prosthetic was misaligned by 2 cm. Once his prosthetic was aligned

correctly, the pain went away. This is what leads me to believe that, in

addition to being an overload or training problem, perhaps there is a

biomechanics inefficiency issue other than excessive pronation that may be at

work here.

The shin splint has perplexed me throughout my 32 year coaching career.

Runners with high, rigid arches tend to experience greater pounding shock, yet

those with flat feet tend to experience greater fatigue of the muscles that

support the foot. Athletes with either problem have developed shin splints.

We've had the best success with deep tissue massage. Others have found that

applying heat in conjunction with deep tissue massage on the effected area

seems to bring the best results.

Ken Jakalski

Lisle HS

Lisle, IL