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shin pain

Health, running, Shin Pain

Shin Pain and Stress fractures – Heal strong and fast

July 16, 2015 • By

marathonTreating your shin pain and foot pain from stress fracture the right way, as soon as possible, means you heal faster and stronger. In this series on stress fractures, I will tell you what a stress fracture is, what causes them and most importantly what rehab exercises and self-treatment you can do to get it right.

Following on from the first post in the series which detailed what stress fractures and stress reactions are and why endurance athletes are so prone to shin pain and foot pain and what to do initially, this post gives you the rehab to help it heal faster, by covering phase 2 and 3 of stress fracture rehab.

Phase 2 – Strength, conditioning and rehab

When to start: Phase 2 of rehab from stress reactions starts when general activities of daily living (walking, hanging out washing etc) can be done without symptoms – Pain is an indication of overload to the bone in many cases, so we need to listen to our bodies.

The main three aspects that need to be covered in home rehab of stress fractures are:

  1. Exercise to maintain cardiovascular fitness and prevent muscle loss
  2. Rehab exercises to address cause behind the injury

So let’s address those:

1. Maintain fitness

It is important to note that in most cases you don’t have to completely rest – there is always something you can do, and very important not to lose fitness. So with that in mind, and the fact that exercise actually boosts healing, here are some things that you could do:

  • Pool training – this can start light, treading water in the deep pool and swimming, progressing to jogging in chest-deep water.
  • Stationary bicycle or exercycle – this is a great way to keep up the fitness without causing pain
  • When poor walking etc is pain-free, begin going for short walks and build this up. Eventually you should be able to walk without pain for 30 minutes at the end of this phase

Tip: Remember, you cannot return to loading the bone until the bone is pain-free to tap on and touch

2. Rehab exercises

These should aim to:

  • Increase muscular endurance
  • Improve core and pelvic stability
  • Work on balance training
  • Address flexibility issues
  • Re-train running pattern

Here are some great options to work on:

Heel raises to build calf endurance

Calf raise, calf exercise, heel raiseLevel 1: Start these on two legs, aiming for 3 sets of 10 reps

Level 2: When comfortable and pain-free, progress to single leg heel raises

Level 3: Goal: 30 heel raises in a row

 

 

 

One leg squats to retrain pelvic and lower limb stability

Single leg Squat, hip stability and strength

Aim for 3 sets of 10 reps.

These need to be done with good technique so it can help to do them in front of a mirror

 

 

 

 

Wobble board balance re-training

Bosu ball, wobble board ankle and calf re-training rehab quick

 

Re-training your balance and coordination of the muscles is very improtant, and easily done with either a wobble board or a Bosu ball.

Aim for at least one minute on each leg.

If you can’t get a wobble board, try rolling up a towel firmly and standing on this

 

 

Stretching:

Calves

calf stretch , soleus, gastroc - self treatment for shin splints

Hang one heel at a time off a step and hold for 30 seconds

 

 

 

 

Hamstrings

doorway stretch

 

MTSS shin splints self treatmentStretch out your hamstrings up a doorway of wall as shown here and hold for at least 30 seconds each side

Alternatively you could use a Foam Roller to loosen up your hamstrings and calves!

 

 

Tip: Continue to ice after exercise and exercise should always be pain-free – a return of shin pain or foot pain can’t be taken lightly.

Phase 3: Safe progression back to full activity

Before starting this phase, you need to be able to do all the previous exercises and painfree and ideally be cleared by your physio or doctor.

When returning to running, a good guideline is to increase activity by no more than 15% to 20% per week. You should also be able to walk for 30 minutes comfortably and you can build this up the same way.

A good starting point, is to run 500m followed by a day of rest or a short walk. If this is pain-free, then you can jog 3 x weekly, ensuring that there are rest days

The distance above is just a guideline but basically start with a short distance and if this is pain-free, slowly increase this, never increasing by more than 15% per week. This is because bones take time to adapt, heal and get stronger – you need to give them this time and only increase in small amounts so as not to overload them.(1)

Numb feet when running lace up properlyTip: when returning to running, it is important to have the right technique – pay a visit to your local sports physio or appropriate professional to have this looked at and also to get some advice on footwear for you as this is very individual (but maybe stay away from minimalist or “barefoot” footwear and aim for motion controlled footwear initially (2)).


Health, Shin Pain

How To Treat Shin Splints At Home

December 1, 2014 • By

shin splint painAre the dreaded shin splints giving you trouble? Here is a video that will show you how to treat shin splints yourself – it is easy, effective and will really relieve tension and pain!

As explained in a earlier post, shin splints is the most common lower limb injury in athletes, affecting nearly 10% of all runners!

For more detailed info about what actually causes “shin splints”, check out the link above, otherwise you can get started right now on this easy muscle release…

 

 

 

It is so important to stick with it and persevere a you cannot sprinkle pixie dust and have this better in a few days, 1-2 weeks and you will feel a real difference, 4-6 weeks and you will be feeling a whole lot better.

Combine this with some good rehab exercises and technique improvement (if you are an athlete/runner) and you will be away!

And remember, reduce how much you wear jandals/thongs/scuffs.

 

PhysioPrescription, giving you the tools and information to help yourself,

Shaun


Health, running, training

Zoom out – Rehabilitation with your eyes open

March 10, 2014 • By

The approach to treatment and rehabilitation is changing and for the better. Gone are the days (going anyway) of just treating the pain and symptoms. This approach lead to :

  • Short term outcomes: Pain relief, symptom relief (muscle spasm etc) and you feeling better.
  • Flare ups and frustration: But the pain kept coming back after these quick fixes.
  • Meaning more money spent in the long-term, more frustration and decreased quality of life.

The reason the quick fix approach doesn’t work for a lot of people is because the cause is not being addressed – The reason behind the pain and injury isn’t being rehabilitated.

When an injury, pain or niggles occurs you need to look above and below the area to find the contributing and causative factors.

Some examples? Here is a couple of common examples:

1. An office worker gets regular headaches that stops them doing what they love, playing on their mind and being very, very frustrating. They have had their neck treated in various ways – acupuncture, massage, trigger point release, joint mobilizations etc. All of these offer release – but they keep coming back!

bad posture and why it causes headachesOften the reason behind this is a rounded thoracic spine (upper back). This rounded spine pushes the head forward in a less than ideal position as you can see in the image to the right. This forward head position, one closes down the joint at the base of the skull and also every centimeter that the head is forward makes the neck muscles work four times harder! This will definitely cause muscle knots and stiff joints at the base of your skull AND headaches. So no matter how much you pull your head back, have the neck treated etc – If you do not treat your spine below the neck – You are going to keep getting headaches.

 

Patellofemoral pain syndrome. self treatment and rehab at home to decrease pain and get you back to it!

2. Another common example that will ring true with a lot of people, particularly runners, is anterior knee pain (Patello-femoral pain). Anterior knee pain is one of the most common running injuries and the pain happens because the knee cap doe not glide in its grove correctly. This is due to increased tension in your quads (particularly the outer quads) – pulling the knee cap laterally (to the outside) causing pain, inflammation and further muscle tension to due it grinding in the wrong place. Studies have shown that runners with PFPS have weak hip abductors and external rotators – This is a huge contributing factor as if these muscle are weak the knee is not controlled, in turns inwards, changing the tracking and position of the knee. So the knee can be treated, taped, dry-needled and exercises etc as much as you like but of hip strength and endurance isn’t improved then this will hang around and really frustrate.

 

 

core strength minimizes lower limb injuryIt is amazing how the body is connected, with no muscles and joints working in isolation. The body is full of synergies, with different muscles and tissues working together to move everything in unison, it really is an awesome machine.

But this is why when one thing goes wrong – multiple other areas can be affected. Other areas help out and work hard to compensate, some parts get more stress through them, leading to pain and niggles, that may bot be where the problem is!

 

This is why you need to rehab with your eyes open. If you have:

Look at your body holistically – Don’t just focus on the pain and getting a quick fix. Health care is changing; less pills, less anti-inflammatories, healthy food and less steroid injections – Become aware of your body and improve it for the long-term and Physioprescription is here to help you do that, giving you the tools, info and exercises to live better!

 

Please share, like and let me know how you get on!

 


Lower limb, running, Shin Pain

Shin Splints Treatment and Exercises

October 14, 2013 • By

runningShin splints is the most common lower limb injury in athletes and can lead to large blocks off training and serious injuries such as stress fractures if ignored. Here you will find out, what it is, what causes it and how to treat and rehab it YOURSELF with effective self treatment methods and exercises.

Shin splints is an Umbrella term that describes pain along the inside border of your tibia(shin) and covers a number of pathologies. The most common and Injury most often associated with Shin splints is Medial Tibial Stress Syndrome.

shin splint painMedail Tibial stress syndrome (MTSS) Is the most common Injury in runners (Lopes et al 2012) affecting 9.5 percent of all runners, coming in just ahead of achilles tendinopathy and plantar fasciitits.  In MTSS pain is felt along the inside border of your shin bone (tibia), it is tender to touch and the tender/ lumpy area is larger than 5cms.

MTSS is caused by repetitive contraction of the calf muscles causing excessive stress on the tibia. The calf muscles (namely the soleus, flexor digitorum longus and tibialis posterior) attach onto the inside border of the tibia, and the repeated pulling from any of these muscles at their attachment causes micro-tears which causes inflammation, pain and excess tissue build up.

Now this generally happens due to one or a number of the following reasons:

  • Sudden increase in training that your body isn’t used to.
  • Change on footwear or training surface, eg. going barefoot (minimalist running) or changing from flats to hill running.
  • Poor hip control causing excessive internal rotation.
  • Over pronated foot type.
  • Poor running form (See Ironing out your running).

 

Differentail Diagnosis:

Stress reaction and stress fracture

These also cause shin pain and can be causes by MTSS or occur by themselves due to over training so it is important to have these ruled out by your Local physio if there is pain when you: tap on your shin bone, jump on your heel or if the pain is localised to one spot on the shin.

 

MTSS is far too often ignored and put aside as calf tightness until it is far worse than is should have got, which means some serious time off training and a lot of money spent on rehab. Below we are going to run through exercises and self-treatment that will both help heal your MTSS/shin splints AND prevent them happening again.

 

Exercises: All of these need to be done 2 x daily if you have shin splints.

calf stretch1. Calf Stretch:  Drop your heel off a step and hold it for 1 minute.

 

 

 

 

 

 

MTSS shin splints self treatment

2. Foam roll your calf: Position as shown in the picture to get as much weight through the roller as you can. Spend 2-3 minutes slowly rolling your whole calf – ignore the pain!

 

Tip: You can also give yourself and self-massage, which is really effective at reducing tension and getting right to the point!

 

 

 

glut and Lat stretch - Hip flexibility

3. Sling stretch for hip range: Hold for 1 minute.

 

 

 

 

 

 

Bridge - increase leg strength, glute activation and decrease back pain.

4. Single leg bridge for hip stability: 

Hold for 5 seconds, 2 x 12 reps each side.

 

 

 

 

 

Single leg Squat, hip stability and strength

5. Single leg squat for lower limb strength and stability: To make it harder and better for lateral stability, keep your free leg out to the side.

Do 2 sets of 12reps each side.

 

 

 

 

 

Make the above exercises a routine even when pain-free!

Self treatment:

The main technique that will benefit you is self deep tissue massage. Check out this post for a easy video demo of this.

 

Tinker with your training:

– Decrease your training load to allow healing to take place

– decrease hill running and running or walking on hard surfaces

– Take a good look at your shoes and consult a Podiatrist of Physio re your foot mechanics.

– Once pain has gone, start SLOWLY building up your training again.

 

 

So there you have it, your guide to Shin Splints Treatment! Take some time to check out some other great posts that will help athletes and runners out a huge amount in preventing lower limb injuries as it is ALWAYS better to prehab!

Iron out your running – run faster, easier and injury free.

Quick balance and stability test.

Glute activation – the missing link

Please Share and like and let me know how you get on!