Not everyone who has a foot problem needs orthotics but injuries are often symptoms that can help identify faulty mechanics.
Shin splints is a misleading term and most sports medicine professionals try to avoid using it. It is essentially a form of Exercise Induced Leg Pain (EILP). Shin pain and ‘Shin Splints’ can be due to several different conditions. One of the most common shin conditions that is frequently labelled ‘Shin Splints’ is Medial Tibial Stress Syndrome.
Medial Tibial Stress Syndrome has been reported to occur frequently in military recruits, distance runners, dancers, football (soccer) players and gymnasts.
Medial Tibial Stress Syndrome and EILP are largely caused by over-use, with those who run regularly on hard or uneven surfaces being particularly affected. However, there are a number of factors, such as altered foot, knee and hip mechanics and posture, which can make one susceptible to the syndrome.
It is important to distinguish Medial Tibial Stress Syndrome from other causes of shin pain such as Compartment Syndrome or a Tibial Stress Fracture. This can require a complex run through of investigations and possible referral for more specialist investigations.
A biomechanical assessment can identify problem areas and prescription orthotics can help improve and often resolve imbalances.
Most patients respond well to conservative treatment. This involves rest, strengthening and stretching exercises, followed by a gradual return to running after symptoms subside. In order to help prevent recurrence of the condition, a biomechanical assessment can be very useful. This will pick up any factors that can cause susceptibility to Medial Tibial Stress Syndrome or EILP, so that they can be corrected before a return to activity.
Muscle imbalance and or a leg length discrepancy can be a cause of faulty mechanics that can be picked up during an assessment. A common cause of Medial Tibial Stress Syndrome is pes planus (flat feet) or a pronated foot position (a lowered arch during gait).
Pronation is a normal and natural part of the gait cycle but excessive pronation is the uncontrolled lowering of the arch of the foot during gait. This puts increased strain on the muscle which pulls on the inside of the shin and can produce pain. Orthotics are very effective in helping to resolve this.
Some of the injuries treated include:
- Achilles tendinitis/Achilles tendinosis (pain at the back of the heel, often with a lump formation)
- Plantar fasciitis/policeman’s heel/heel spur syndrome (painful condition caused by the plantar fasciia being overly stretched, common when the foot excessively pronates)
- Compartment syndrome
- Patella-femoral syndrome
- Iliotibial band syndrome
- Stress fracture management
- Metatarsalgia (ball of foot pain)
- Morton’s neuroma
- Heel pain
- Arch pain
- Knee pain
- Low back pain
- EILP (exercise induced leg pain)
- Medial Tibial Stress Syndrome
Tight muscle groups are identified and appropriate therapy advised including stretching and home physio programmes.