They’re the serial destroyer of intense training sessions; shin splints are both painful and counter-productive. Professional fighter and osteopath Rosi Sexton gives you the lowdown...
Shin pain is a common complaint amongst MMA fighters. A typical scenario is that a fighter finds himself with a fight coming up and weight to lose. He begins running, or perhaps skipping, to lose the weight. Within a few weeks he starts to experience shin pain.
At first, it’s only painful after he’s been running for a while, but gradually the problem increases until even walking is uncomfortable.
What are shin splints?
The term ‘shin splints’ is commonly used to describe pain along or just behind the shin bone that is brought on by exercise.
Because there is some confusion (even amongst practitioners) as to exactly what the term shin splints refers to, we’ll mostly avoid using it. Instead, we’re going to talk about the most common conditions that can cause shin pain in athletes.
Medial tibial stress syndrome (MTSS)
This condition leads to the classic pain described as shin splints.
It is characterized by gradually worsening pain along the border of the shin bone that comes on during exercise (most commonly running or skipping). It is thought to be a result of trauma and irritation caused to the tendons and lining of the bone.
Factors that may increase your chances of developing MTSS are:
- Running on hard surfaces
- Sudden increases in training volume
- Running in worn out or badly fitting trainers
- Increased weight
- Having flat feet
- Short, tight calf muscles
- Poor running mechanics.
For fighters with certain foot types, spending a lot of time training barefoot on mats can also cause problems. In this case, specific conditioning work for the muscles of the foot, leg and hip can sometimes help. A knowledgeable sports physiotherapist or strength and conditioning coach should be able to point you in the right direction.
Stress fracture
Stress fractures can result from repetitive minor stresses to the leg, for example when running on hard surfaces.
These may require up to 12 weeks before you can return to your previous levels of activity.
It is sometimes tricky to distinguish between MTSS and a stress fracture of the tibia, and X-rays may come back normal in the case of a small stress fracture. Often the first clue will be that the pain doesn’t seem to be improving as quickly as expected.
Sometimes a bone scan may be recommended to confirm the diagnosis. Sparring or fighting with a stress fracture is not advisable, as any weakening of the bone may increase your chances of a bad break upon impact.
Chronic compartment syndrome
Compartment syndrome is less common than MTSS or stress fractures, but can sometimes be mistaken for one of these conditions.
It is caused when blood flow increases to the muscles of the lower leg and causes a build up of pressure. In most people, there is sufficient space to allow for this increase, but sometimes (perhaps due to rapid muscle growth from intense training or steroid use) the connective tissue forming the compartment is too tight.
When this happens, the blood flow to the muscles becomes restricted causing pain and muscle damage. In some cases, the nerves to the lower leg may also be affected leading to tingling or numbness in the foot.
Usually, this type of pain comes on during exercise and is relieved with rest. It can sometimes be relieved by stretching and manual treatment, but to give lasting relief a minor operation to relieve the pressure is often required.
Direct impact trauma to the shin
This is an obvious cause of shin pain in fighters. Repeated shin-on-shin contact when training Muay Thai, for example, can cause shin pain that takes a surprisingly long time to go away.
Most fighters reduce the risk of damage during training camps by wearing shin pads during sparring sessions, and conditioning their shins gradually while working their kicks on Thai pads or a heavy bag.
For the inexperienced, trying to toughen your shins up by striking them against hard objects such as banana trees or even lamp posts is likely to cause more harm than good.
Direct impact damage often occurs in combination with the other causes of shin pain mentioned above.
This compounds the situation, and can make fighters especially vulnerable to lower-leg complaints.
Treatment
In the short term, mild shin pain often responds well to the use of cold packs. You should modify your activities as much as possible to avoid things that cause the pain. If running or skipping hurts, then consider switching to a lower impact form of training such as cycling or swimming for a few weeks.
If the problem persists or keeps recurring then consider seeing a healthcare professional such as an osteopath, physiotherapist or podiatrist for advice about your specific symptoms. Straightforward cases can respond very well to hands-on treatment if they are caught early enough; and sometimes a change of running shoes or the use of insoles (recommended by a podiatrist) can be enough to solve the problem.
When to see your doctor
You should see your doctor immediately if the pain is severe, or if it follows a fall or accident. Other warning signs include worsening swelling, a shin that is hot and inflamed, or pain that persists during rest.
Things that may help to reduce your risk of shin pain:
Make sure that you have a good pair of trainers. Depending on your foot type and how you run, you may need different types of running shoes. Many running shops offer a ‘gait assessment’ which may help you to choose the right shoes for you.
Build up your mileage gradually. Sudden changes in the volume of your training (and running in particular) increase your chances of getting shin pain. Wherever possible, you should allow enough time in a training camp to steadily increase your training volume.
Warm up correctly before training.
Stretch your calves! Short, tight calf muscles cause changes in the mechanics of how you run, and these changes could increase your chances of developing problems.
If you have ongoing problems with shin pain, then consider seeing a podiatrist for a full assessment of your feet and running mechanics. There are no ‘one size fits all’ solutions.
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