As awareness of the importance of health and exercise continues to grow, so too has the incidence of particular injuries that present at our clinic due to people taking a greater interest in, and participating in, higher levels of physical activity. One such injury has been the presentation of shin pain. But it can sometimes be difficult to decipher between shin pain that is related to stress fractures of the tibia, and that which occurs due to a compartment syndrome or tenoperiostitis. So how do we determine the precise cause of your patients shin pain and does it ultimately affect how we manage them to get the best outcome.
In our clinic, we find the most important aspect to correct diagnosis of shin pain is a thorough history taking. Pain that improves with exercise is more likely to be periosteal in nature, whilst feelings of tightness or sensations of numbness, pins and needles or a ‘dead foot/leg are more suggestive of compartment syndrome. If pain is increased by jumping or your patient experiences a pain at rest or a night ache, and the main site of tenderness is along the tibia, we must consider a stress fracture as the underlying issue. It is however important to keep in mind that two, or even all three, of these conditions may co-exist.
While the exact cause of your patients shin pain may vary, their management may be similar irrespective of the underlying pathology. Physiotherapy treatment for all three conditions will generally involve an initial period of rest and correction of any soft tissue dysfunction. It is then vital that a thorough examination of foot function occur, as poor biomechanics, along with incorrect training techniques, are the most common reasons your patient may be experiencing pain in the area of the shin. If correction of such biomechanics is unable to be achieved by simple strengthening and stretching, orthotic correction of the foot may be required. It is then vital that the individual grade back into their exercise routine using the general principles of injury management following an overuse injury.
If you have any patients suffering from shin pain, and believe they may benefit from physiotherapy assessment, or should you believe that a patient may be at increased risk of developing shin pain due factors such as poor foot mechanics, inadequate footwear, over training or reduced bone density, please contact our clinic on 03 9716 2250 today for an assessment with one of our experienced therapists.