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April 2, 2016

You hit the pavement, walking or running, to achieve whatever fitness goals you set for yourself.  Then this dull, burning, annoying pain creeps up the front of your lower leg; limiting your performance and hindering your success.  You think shin splits.

I hate shin splints! I’ve changed shoes, tried countless inserts and arch supports, rested for weeks before walking/running again but they never go away.

Does this sound familiar?

If you aren’t an athlete or avid runner who’s recently intensified your training routine, chances are, the pain you’re experiencing isn’t shin splints. I can’t count how many times someone has approached me with questions on how to achieve weight loss if they aren’t able to walk or run an extended period of time because of shin splints.  Before thinking about training routines, my first question is –

Where does it hurt?

More times than not, they point to the outside of their shin at the anterior tibialus muscle – responsible for dorsi flexion (opposite of a calf raise) of the ankle joint. Far from where the shin splint pain would be experienced, near the inside portion of the shin, (along the edge of the shin bone.)  Immediately, I know I can have them walking/running in as little as 20 minutes, virtually pain free.  All because the pain they are trying to overcome is directly related to the muscle itself and the connective tissue around it.

Several groups of muscles located in the lower leg are responsible for movements like flexion/extension of the ankle joint, like pointing the toe and rolling the foot in and out.  Most commonly: the anterior tibialis muscle that runs along the front outside portion of the lower leg, the peroneus longus muscle that runs along the direct outside portion of the lower leg, and the calf muscles (gastrocnemius and soleus) that run along the back of the lower leg are responsible for how the foot and ankle move and help create the force to provide forward/backward movement.  These muscles are working constantly and become very tight and tense without us even knowing. They can contribute to knee and ankle pain.

Almost all of us have heard of massage therapy, trigger point therapy, and myofascial release therapy. And we’ve all seen these big round Styrofoam tubes hanging at the gyms that people climb on top of and roll about.  These tubes are tools that can be used to help perform these types of therapy from a ‘self’ prospective (i.e. self-myofascial release).  If you haven’t the slightest idea about these forms of alternative medicine, type in ‘MFR techniques’ into a search engine and you will have bathroom material for days.

Now to return from the tangent; with the amount of work being done by these muscles, they need a little love from time to time and what I do with those who have incorrectly diagnosed themselves with shin splints is give that love.

I have them sit or lie in the crunch position with one leg straight in front and the other remaining bent.  On the bent leg, I take one hand and place it on the inside of the knee while taking a lacrosse ball (massage balls work great, too) and apply pressure to the muscles of the lower leg from just below the knee to about three to four inches above the ankle joint and work up and down, left and right until I find problem areas.

Although, I can tell by the way the muscle feels beneath the ball where these spots might be; another indicator is the sweat beads that run down the brow of the client as they start to squirm and wince with discomfort.  I apologize but this isn’t something that is very enjoyable but the pain is necessary to ensure great enough tension to cause the muscle to relax and to loosen the surrounding fascia tissue, so… LEARN TO LOVE IT!

Once a problem area is targeted: slow the rolling to a stop, keep steady pressure for about 10-15 seconds then slowly roll off the area.  I’ll keep moving up/down and across the leg searching for more painful spots and applying steady pressure to each of them, periodically going back to each spot for about ten minutes.  Then, I repeat the process on the other leg.  After isolating the muscle with a ball, I’ll take a hand held roller (similar to a dough roller, which will work wonders if it’s all you have) and make about 10-20 passes up and down the lower leg.

Once complete, I perform: a calf stretch by flexing the ankle toward the front of the knee and curling the toes in the same direction, an anterior tibialis stretch by doing the exact opposite movements of the calf stretch and an easy stretch to the peroneus/fibularis muscles by keeping the ankle at 90 degrees or the sole perpendicular to the ground then lightly forcing the sole of the foot toward the inside while slightly tilting the toe in (supination and eversion of the foot), all done with a straight knee.

After holding these stretches for 20-30 seconds, I help the client up and have them try out their new set of legs!  This process will need to be repeated periodically but the good new is, it will probably never be as painful as the first time around.

Happy Treading!

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