Before we get to the reasons your still in pain after all this time. I’m going to tell you a story and question, at least the last 15-20 years of treatment for shin splints pain. In my view, over pronation is an old fashioned, poorly constructed theory for why shin splints develops. It causes tunnel vision and prevents us as practitioners and our patients from doing the necessary work to uncover the truth.
Shin splints is an old fashioned term like ‘blithering’ or ‘applesauce’. It broadly describes pain in the shin area. Which can be anything from excessive bone strain to bone stress to the fully developed stress fracture. Some people would even throw compartment syndrome into the mix, even though personally I would put this in a slightly different category. The most common, the stress syndrome a by-product of excessive bone strain over time, can develop on either inner (medial) or outer (lateral) aspects of the shin or tibia. Characterised by the stress laid out on the lower tibia from the constant yanking from muscle attachments along this wall.
Back a couple of years ago, when we were early to primary school, we were made to run around the oval non-stop until the bell would ring for the start of school. My parents, eager to get rid of me for as long as possible, would drop my off 30 minutes before school. I was a lean kid, so the little amount of muscle I had on my lower legs would cling to the bone like whiskey to a Scotsman.
The combination of this in school shoes that weighed the same as me at the time, in addition to the growth I was going through, meant that my muscles already weak and strained had to work over a longer distance and under more duress. In addition, I was now sitting in school more, apart from a short game of pokemon on the lawn at morning tea. So this was the true concoction for bone stress, not the over pronation theory I was thrown by multiple practitioners.
Here’s the deal. Take the blue pill, and you can close this blog and continue on with your life and shins the way they are. Take the red pill, and I’ll show you the real reasons your shin splints aren’t improving with rest, ice, anti-inflammatories and those orthotics.
1. You're looking down the wrong Rabbit Hole
When you look down the rabbit hole. All you see is a pair of bright blue orthotics giving medial arch support. You switch them between shoes, work shoes, running shoes, golf shoes, tennis shoes, dancing shoes. After a while they become part of you. You believe you can’t sleep without them. I’m going to annoy a lot of people when I say this, but I believe orthotics are just an easy road the practitioner takes to fix a more complicated issue and a money making exercise.
2. You’re not putting in the Time & Money to get the problem fixed.
Sometimes I’m fascinated that individuals will go a spend $2000 on getting their triumph serviced and fixed because they don’t want any issues getting to and from work. Yet tell people, they need to spend a few hundred to get their foot, ankle and leg fixed, so they can run and be active without pain and they hesitate.
I’ve seen 1000’s of clients over the years. I’m yet to see anyone who hasn’t improved if they put the work in, and listen to our instructions.
See a practitioner regularly early, follow their advice, don’t try and spread appointments out until they say so. Otherwise you’re delaying the rehabilitation and you’ll end up spending more in the long run.
3. You believe the Over pronation hype
You use to have cool shoes to run in. Now you run in a shoe that looks like a toned down version of the titanic. It's black or white, and sometimes when you put them on your partner walks 5m behind you.
Let’s be honest here. Your feet don’t one day start over pronating. You didn’t go to sleep with medial arches in your midfoot and wake up the next morning with flat feet.
You need to start out by utilising a practitioner with specific skill sets like those at Evolutio to find out what is working well within the 26 bones, 33 joints and 19 muscles in your foot. Improve this first then work up the leg, to improve deficiencies and compensation that has occurred as a result.
Pronation is actually necessary when you run believe it or not. The action causes force transfer through the foot, ankle and lower leg.
So don’t have tunnel vision. Open your eyes to what else could be causing your shin splints. If you come to us with your orthotics. Be careful, we might throw them under a bus.
Here’s another interesting story. Shin splints in the Military is an extremely common occurrence, especially with new and young soldiers.
I can guarantee that you can’t pronate in a military boot. In fact you can’t usually feel your toes in one. So if this is the case, wouldn’t it be more realistic that suddenly constantly pack marching, running, jumping and patrolling in a boot that weighs more than 3-4 x (when dry) a normal jogger would cause massive strain on weak and under developed lower leg muscle groups, therefore causing a version of bone stress? Rather than over pronation?
4. You’re not seeing us at Evolutio Sports Physio
Enough said. We’re a friendly crew. Drop us an email at firstname.lastname@example.org, or swing by our cool clinic in Richmond and say gday.
“Sooner or later you’re going to realise just as I did that there’s a difference between knowing the path and walking the path” –
One of the dudes from the Matrix.
Alex Drew is a Physiotherapist and Founder of Evolutio which is now located in Richmond, Melbourne and has recently been voted the number one physio clinic in Australia by the customers at the local 7/11.
Evolutio specialises in Physiotherapy and Podiatry treatment for high level Sporting athletes, CrossFit athletes, Powerlifters and Olympic Lifters.