Lower limb injuries are common in both active and inactive individuals. Knee and IT band injuries used to be prevalent but now along with those, there has been a recent increase in pain over the shin area. The most common symptom is pain in the shin muscle- the tibialis posterior which is located on the inner aspect of the foot and has a function of supporting the arch while walking or running.
Presentation of pain in active and inactive individuals:
Highly active individuals usually carry some fatigue due to regular training and compromised recovery. When these individuals increase their speed of running which is typically seen in sprints and interval training it leads to an increase in movement of the arch causing excessive fatigue and stress on the muscles. The muscle which usually gets punished for this is the tibialis posterior which causes pain over the shin bone or over the arch of the foot.
In inactive individuals, the reason for shin pain is slightly different when compared to active individuals. While active individuals push their bodies to the absolute maximum inactive individuals do not strengthen their muscles at all and suffer from shin pain as a result of muscle weakness. So, whenever an inactive individual needs to undertake a slightly strenuous activity, the muscles cannot carry out the required work efficiently due to muscle weakness.
While the muscles can support the arch of the individual for some days, when the muscle weakness is coupled with impaired recovery is when the pain starts to increase and sustain.
This can also occur due to a sudden shift from shoes with a heel drop to shoes with no heel drop leading to discomfort and pain.
Advice for individuals:
Active individuals should monitor their activity level and avoid overtraining while focusing on their recovery. On the contrary inactive individuals are suggested to strengthen their tibialis posterior, and other calf muscles to prevent the incidence of shin pain.
If an individual has a flat foot or high arches, they are advised to visit a foot specialist to undertake a detailed evaluation of the foot. A Physiotherapist or Sports Scientist can help individuals monitor their activity level, assess foot mechanics, and assist in recovering, reducing the chances of shin pain drastically. A foot and ankle specialist can specially design an insole for individuals depending on their foot type. This in turn can reduce the speed of arch collapse thereby reducing the stress on the tibialis posterior (Shin muscle).
Individuals irrespective of their activity status are suggested to undertake regular blood check-ups to monitor their vitamin D levels along with other important parameters.
To conclude, shin pain is typically caused either by load mismanagement, lack of recovery, muscle weakness, vitamin deficiency, altered foot mechanics or a combination of all the parameters. In severe cases, it may be due to stress fractures. However, if appropriate treatment or management is undertaken the incidence of shin pain can be reduced drastically.
