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Get Rid Of Your Shin Splints

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Get Rid of your Shin Splints QQQURESHI Kneesovertoesguy

Have you ever felt like someone was stabbing your legs? After finishing a run through, you lay down on the ground spread eagled, almost as if you’re about to make a dust angel on the ground of the nasty floor you spent the past 2 hours dancing on. As you close your eyes, you feel this sharp stabbing pain on your lower leg. It’s towards the front, not really your calf. It feels like someone is taking a super sharp fork and just lightly stabbing at it. It feels hot. Every time you move your foot or legs you feel this hot, sharp, pincer like pain radiate on you legs.

I’m going to tell you how to never have that pain ever again.

What you, I, and every dancer at one point are experiencing is shin splints. Before I get into how to fix it, I’m going to bore you with my “vast knowledge” as a third year medical student about what MTSS actually is. If you want to skip this part, it’s fine, *cries* I won’t get hurt *cries more* my feelings are unimportant *sobs* I just want to help *whimpers in fetal position*

side note I also have a podcast and we talked to a physical therapist who has done Bhangra so you can also listen to this

What is a Shin Splint?

In medicine, a shin splint is also known as medial tibial stress syndrome (MTSS). Medial meaning closer to the middle of your body, tibial meaning your tibial bone of your lower leg, and stress syndrome meaning all the additional, repetitive load and work that is applied.

More or less what is happening is that your legs have taken a beating and haven’t had time to fully rest and recover. You’re not taking care of yourself. Dancing through this is only going to make it worse.

How do Shin Splints Happen?

Allow my medical student persona to indulge you in the anatomy and super duper details of MTSS. Now there are a number of different potential causes of MTSS, I’ll go over some of the more common ideas and mechanisms.

Mechanisms and Anatomy of Shin Splints

The layers of bone credit

1. One commonly accepted idea is that you’re slowly accumulating tiny little microcracks in the cortex of your tibia. Cortical bone is a super strong but thin outer layer of your bone. As you expose your tibia to further stress in the form of dancing, jumping, running, etc, you increase the number of cracks → inflammation → pain → crying.

2. Another idea which kind of goes hand in hand with this is that when you apply new stress to your bones anywhere, your bone grows. As your bone grows, it may grow faster than the cortical layer of your bone and induce the cracks → inflammation → pain → crying.

3. One commonly accepted idea is that you’re slowly accumulating tiny little microcracks in the cortex of your tibia. Cortical bone is a super strong but thin outer layer of your bone. As you expose your tibia to further stress in the form of dancing, jumping, running, etc, you increase the number of cracks → inflammation → pain → crying. 

Plantar flexion and dorsiflexion credit
Muscles of the lower leg, cross section view credit
Muscles of the lower leg, posterior view credit

4. Similarly along the lines of that idea is that when you contract any of your muscles anywhere in your lower leg, you create tension between the different compartments of your leg. Your leg muscles are connected by this tissue called fascia. Think of it like this thin stretchy glue like substance. When you apply tension to the fascia repeatedly over and over again → inflammation → pain → crying.

This is fascia credit

5. Lastly, there’s this idea about inflammation of Sharpey’s fibers. Sharpey’s fibers are these tiny fibers that pierce the bones and kind of hold everything in place. They’re made of super thin collagen and help anchor everything. When they get strained, through some physical activity causing muscle contraction, they pull on the bones they’re connected to. That pulling stress causes the bone to grow → cracks → inflammation → pain → crying. 

Sharpey’s fascia zoomed in credit
Location of Sharpey’s fascia around the tibia credit

How Do I Fix Shin Splints?

So now you know that shin splints are essentially increased stress on the muscles and the bones of your lower leg. When your muscles and bones are introduced to stress that they’re not used to they grow and stretch on each other and induce a ton of pain. Shin splints are pain from fatigue and work that they’re not used to dealing with.

An easy way to fix that, is to stop. Let your legs heal. Ice them. Stretch them. Rest them. These methods have been spoken about ad nauseam. You know this already. Let me give you some advice that my younger self might have actually listened to.

Another way to think about MTSS is that you need to get your legs used to this level of work. To do that, you need to target and strengthen them. Do these two exercises everyday and your shin splints will get better.

If y’all have heard of the kneesovertoesguy, then you’ll be familiar with these exercises.

Anterior Tibialis Raises

This exercise targets your anterior tibialis muscle. It’s the muscle that allows you to dorsiflex your foot (point your toes up). It’s the muscle that is huge for stabilizing your knee under strain, improving your ankle mobility, and in this case also gets worked over when you do Bhangra.

To do anterior tibialis raises all you need to do is put your back to a wall with your legs straight out in front of you like below. Be sure to put your hands on your knees to make sure that your legs stay straight the entire time. If you bend your legs, you don’t put pressure on the anterior tibialis and the exercise won’t work.

From there all you do is flex your toes and then put them back down. The movement is controlled but fast. Don’t need to hold the contraction or anything. When you do Bhangra, you’re not contracting your anterior tibialis for a long time, you’re just contracting for a little bit when you jump or move.

Bottom of contraction
Peak of contraction

To make the exercise easier just bring your feet closer to you. To make it harder move them farther away. Do 4 sets of 25 reps everyday.

Make it easier by bringing legs closer
Make it harder by pushing legs farther

You can do this exercise pretty much anywhere. I’ve done them leaned up against my desk at the hospital, waiting in line, it’s a super easy exercise to squeeze in everyday.

Calf Raises

This exercise targets your gastrocnemius and soleus muscles. These are your calf muscles that ache after walking around in heels all day or after a long practice. Super important for jumping, running, and overall strength of any leg movement.

One thing that I want to emphasize with this calf raise is range of motion. You may have been told you can do calf raises just standing on the floor and flexing your feet. While this is better than doing nothing, you’re not getting that full range of motion. When you do a calf raise with full range of motion, you’re not only strengthening your entire calf but you’re also getting a stretch along with it which is just as important.

To do this exercise get on a wall with your arms out and put your feet back to the point where your heel is barely touching the ground. This is where your calf is 100% stretched out so you can ensure a full range of motion during the contraction of the calf.

From there all you need to do is go flex your calves to peak of the contraction and go back down. Do 4 sets of 25 reps everyday.

I hope that’s helpful for y’all. Let me know if you want me to do more breakdowns of prehab things you can do for Bhangra. Let me know if this stuff works for y’all or not. If it doesn’t work let me know, I’ll be glad to troubleshoot with you.

Much love,

QQ

References

Aaron J. Periosteal Sharpey’s fibers: a novel bone matrix regulatory system?. Front Endocrinol (Lausanne). 2012;3. doi:10.3389/fendo.2012.00098

Franklyn M, Oakes B. Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments. World J Orthop. 2015;6(8):577-589. Published 2015 Sep 18. doi:10.5312/wjo.v6.i8.577

Matin P. Basic principles of nuclear medicine techniques for detection and evaluation of trauma and sports medicine injuries. Semin Nucl Med. 1988 Apr;18(2):90-112. doi: 10.1016/s0001-2998(88)80003-5. PMID: 3291129.

McClure CJ, Oh R. Medial Tibial Stress Syndrome. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538479/

Mueller MJ, Host JV, Norton BJ. Navicular drop as a composite measure of excessive pronation. J Am Podiatr Med Assoc. 1993 Apr;83(4):198-202. doi: 10.7547/87507315-83-4-198. PMID: 8473991.

Oakes BW. Tibial pain or shin soreness (“shin splints”)-its cause, differential diagnosis and management. In: Draper J, editor. Second Report on the National Sports Research Program. Canberra, Australia: Australian Sports Commission;; 1986. pp. 47–51.

Reinking MF, Austin TM, Richter RR, Krieger MM. Medial Tibial Stress Syndrome in Active Individuals: A Systematic Review and Meta-analysis of Risk Factors. Sports Health. 2017 May/Jun;9(3):252-261. doi: 10.1177/1941738116673299. Epub 2016 Oct 1. PMID: 27729482; PMCID: PMC5435145.

Winkelmann ZK, Anderson D, Games KE, Eberman LE. Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review. J Athl Train. 2016 Dec;51(12):1049-1052. doi: 10.4085/1062-6050-51.12.13. Epub 2016 Nov 11. PMID: 27835043; PMCID: PMC5264561.

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