Dr. Kemenosh, Dr. Gross, Dr. Evans, and Dr. Legath treat a lot of runners in the South Jersey area for Shin Splints using Active Release Technique. ART attacks shin splints differently than most other therapies and often yields better results. The one thing Dr. Mark has built is a reputation with the local cross country teams on the best treatment possible for most foot, knee and leg aches and pains.
Before we get down to what we do for shin splints, we should discuss what shin splints actually are. Most commonly, runners, dancers, and military recruits are diagnosed with shin splints, however, anyone can get them. Medically speaking, medial tibial stress syndrome is the term used more commonly to determine shin splints, but anyone who has been a running club knows shin splints are bit more than just medial tibial pains, as they can also bite you on the posterior side of the tibia in some cases. Patients often find that when they go untreated, pain can often then extend in the knee, ankle, or foot. This is most commonly from your brain automatically trying to change your gait (running) pattern to stop pain in the shins. So, overall, if you have shin splints, you may notice tenderness, soreness, or pain along the inner part of your lower leg. You may also notice mild swelling in the leg, usually below the knee, but above the ankle.
So that you are aware, MOST cases of shin splints can be treated on your own! Yes, we said, you can treat shin splints yourself, up to a certain point. Some very helpful methods of home treatment including resting, ice, topical pain relief creams. Some runners also intentionally seek out softer trails and find this helps to some degree, running on a mulch trail versus a concrete sidewalk can often make a small difference. Another part of shin splints we find commonly are the shoes! Worn out shoes or the wrong type of running shoes can often cause your shin splint and leg pain issues. We will recommend our favorite shoe people at the end of this article. Pain while running and exercising to a small degree can be considered normal in patients with shin splints, however if the pain levels rise to a point of being uncomfortable, unavoidable, or lingering longer than the run, you may need to seek medical help.
When is a good time to think about seeing Dr. Kemenosh and Associates about your shin splints or leg pains?
If rest, ice, and basic over the counter pain relievers are not helping your pains, it’s time to seek a medical professional. If you have read along to this point, then you are probably rubbing your shins and thinking about what to do next. Shin splints are most commonly caused by a repetitive stress of the muscles which anchor onto the shin bone (tibia). The Active Release Technique employed by the doctors here at our office was specifically designed for treating repetitive stress injuries. First, during your examination we will zero in on the structures which are truly injured and being over stressed. Once these structures are identified, we will select ART Lower Extremity Protocols which will most commonly attack some of the following structures. Tibialis Anterior is usually the key player in shin splints. Tibialis Anterior is a very strong muscle that stabilizes and controls movement of the ankle and foot. Often, runners who are just getting started for the season or are ramping up their mileage will overload the Tibialis Anterior muscle which can start to overload the periosteal attachment of the muscle onto the Tibia (shin bone). Healing of attachments like these are often fairly slow and is an area that commonly is referred to as “less resilient” by most medical professionals. Runners often try to run again, and the “less resilient” area refuses to lengthen properly during the running motion, as it is still in a state of healing and fibrosis of the structures further shortens the tissue. The results of this cycle is increased pain with running, and all of it is related to overuse with proper attention to treatment. If it helps, the muscle should work like a rubber band to help absorb force during running, but instead acts like a tight rope which has no give.
We also do not simply blame the Tibialis Anterior muscle, we also commonly find fibrotic spots of tissue in the Extensor Hallucis Longus and Extensor Digitorum Longus. Outside of these three main structures, we also commonly treat the Gastrocnemius and Soleus muscles of the posterior compartment which are the muscles that make up your calves.
The muscle that is not commonly treated by other medical professionals when working on shin splints is the Tibialis Posterior. The “Tib Post” as we like to call it around the office is often the muscle that patients don’t like us to treat while they are experiencing running/exercising related shin pain issues. So why do we work on the Tib Post muscle, it is a very strong and deepest central muscle in the calf. Because it is rarely truly treated on patients with shin splints, you are simply buffing the exterior of the car without cleaning out the exterior. With proper treatment of this muscle, as well as the muscles listed above, we seek to break down fibrotic tissue using specific, strong contacts with active motion and this again allows your muscle to function as a rubber band, lengthening and shortening normally, and less like a rope.
Please note that in some cases, imaging can be necessary to rule out the possibility of a stress fracture and stress reactions. In treating some cases of shin splints, we also watch out for a possible issue related to extensive degradation of the structures known as compartment syndrome, which while rare, is something we always keep on the possible differential diagnosis.
So, if you are having shin pain, shin splints aka Medial Tibial Stress Syndrome with activity and would like to give the team at Dr Mark Kemenosh and Associates to examine and treat you, please call us today! 856-228-3100
If you are not located in the Philadelphia or South Jersey area and need a certified ART provider, please look at http://www.activerelease.com/providerSearch.asp
Follow Dr. Kemenosh and Dr. Gross on Facebook at http://www.facebook.com/DrMarkKemenoshandAssociates
If you are feeling that your shoes are a serious problem, do not just trust a big box running shoe store to get you fitted properly if you are running in pain. The two stores that we work extensively with are:
Dave at the Haddonfield Running Co. on Facebook at https://www.facebook.com/pages/Running-Co-of-Haddonfield-Moorestown-Mullica-Hill/113718775305658?ref=ts&fref=ts
Moe at The Sneaker Shop of Ocean City on Facebook at https://www.facebook.com/thesneakershop.ocnj?fref=ts