All of the muscles in your lower leg cross either the ankle to the foot or cross your knee. This means that they are subject to poor biomechanical movement at either joint. Shin splint and calf pain is a common consequence of poor biomechanics resulting in miss-timed movements at your ankle and/or knee joint. This places stress in the muscles and ligaments as they try to control and stabilise your joint function while you walk or run. There is no one size fits all solution to pain in your shin or calf. Your individual movements must be assessed and realigned to ensure your treatment is successful for the long-term.
"After seeing Ian for a short appointment he quickly identified the cause of my calf and knee pain and gave me helpful advice to reduce it. We then discussed what we should do next to stop it happening again".
Annie Cane
Shin splints (medial tibial stress syndrome)
Shin splints specifically, are an enlargement of the muscles on the inside of your shin-bone. This enlargement builds pressure within the muscle compartment and causes pain and sometimes swelling. This pain is most often the result of increasing your activity level too quickly, it can be relieved with rest and we recommend a gradual increase of activities such as walking or running. Keep in mind that “shin splints” is an ‘umbrella’ term used to describe the pain in the front or on the inside of your shinbone. If your shin pain persists or returns when restarting exercise, even after rest or physical therapy treatment, you almost certainly have a biomechanical problem. If your foot, ankle, shin-bone (tibia) or knee, are not functioning well you may suffer from one of a number of conditions, which come under the umbrella of medial stress syndrome (shin splints).
These are broadly separated into two types:
1. Those affecting soft tissue
Conditions such as flat or high arched feet or even poor core stability may result in poor mistimed movements within your foot, ankle, shin and knee. Depending on the precise time and magnitude of the damaging movement there are several structures, which will cause swelling and induration (hardening of soft tissue). For example;
a. Your tibialus posterior or anterior; the muscles that slow your arch are flattening, may become stressed as they are over worked.
b. Your Flexor Hallucis Longus may become stressed as it fights to hold your big toe on the ground.
c. Your Soleus, the smaller of your calf muscles, may start to pull away from your shin-bone as it fights to stabilise your ankle.
2. Those affecting bone
The tibia may become compressed, by your body weight and gravity, or experience a damaging twist, from poor foot or knee function. This results in microscopic fractures that may then move to your bone marrow and eventually cause a break.
If you have recently increased your activity and your shins have started hurting, rest is your best treatment, followed by a more gradual increase in your activity level. If your shin pain is causing you concern or discomfort you should seek professional advice. If your shin pain does not go away or returns frequently you almost certainly have a biomechanical problem. This must be assessed and the exact magnitude of your damaging movement uncovered through gait and foot pressure analysis. Treatment may involve stretches and strengthening exercises, orthotic prescription and footwear advice.
For more information about how you get injured and how to recover from injury see the science bit.
Calf pain
There are many problems that cause pain in the calf. There are three major muscles that make up your calf; the two heads of your Gastocnemus and your Soleus. And also, deep beneath these muscles you have the long muscles, which hold your toes to the ground and pull your ankle in and out, giving you the long arch of your foot.
Pain in your Gastrocnemus (the large muscle body at the top of your calf) is often a result of poor hamstring function and/or poor biomechanics at the ankle or knee. As this muscle crosses both ankle and knee joints it can be pulled in two directions at once while taking up to 12 times your body weight..
Your Soleus is a smaller muscle that runs between the two heads of your Gastrocnemeus. As your Soleus only crosses your ankle it takes load for longer during your step. It is often overlooked in stretching programs but if it is tight it can give you flat feet or high arches, depending on your biomechanics.
If the muscles which control your toes or ankle are used too much or at the wrong time due to your poor biomechanics, the result is often pain in the calf.
As with shin pain, calf pain can often come on if the muscles are used in a way they are not use too, for example beginning an exercise program, or changing your footwear. However if pain persists after a period of rest or physical therapy you almost certainly have an underlying biomechanical problem which must be addressed to allow your body to heal and stop your pain returning. The precise cause of your pain must be found and eliminated through integrated foot pressure analysis and appropriate advice and if necessary orthotic prescription.
For more information about how you get injured and how to recover from injury see the science bit.
Achilles tendon pain
Your Achilles tendon has to control and direct the forces generated by your whole body as they enter the foot, and those coming from your impact on the ground as they pass into your leg. This can be as much as 12 times your body weight. Your Achilles tendon is made up of the tendons from your Gastrocnemeus and Soleus, and has a unique structure. There are several distinct problems that can occur at your Achilles as a result of the movements it has to help control, including pronation and supination plus ankle flexion. All this while it is slowing down the movement of your leg and body as they try to pull your foot off the ground.
Achilles pain appears in many forms, and each form is caused by different movements or your unique Biomechanics. Because of this, treatment has to vary for each individual case. There is no one size fits all solution. Providing treatment for the wrong type of pain can actually cause further damage. This is why an in-depth analysis is necessary. If left untreated, repetitive trauma from walking and running will cause the tendon to degenerate and can lead to a chronic condition. This can then result in injury in other joints as you adjust your gait pattern and place stress elsewhere in your body.
For more information about how you get injured and how to recover from injury see the science bit.
