It’s the Victim that Complains

One of the local track coaches has an athlete who is suffering from shin splints. Does anyone have any experience with this or able to point me in the direction of someone who might? I realize there would be a definite advantage from the increased circulation but anything more specific would be great.

Shin splints obviously have a local etiology involving the muscles of the anterior ankle and shank.
But their inflammation rarely have anything to do with these particular muscles or the foot. They can be at fault or contributing, but the main culprits are often absurd volume and underpreparedness through the hips and core.
Think of this analogy. 2 men show up to a job. One does all the work while the other jokes around. Who complains? The one doing all the work, the one doing everything right. The shin splints are actually doing everything right working overtime because of other areas not contributing. This should be identified with good screening and/or assessing.
Of course increased circulation could alleviate some symptoms, but I would not expect that relief to last much into a training session or long term without finding the true problem.

· Back or connective tissue Issues. Should the client be treated with strength training protocols or massage for inflammation or both? Does the training vary for the area of the back affected (i.e. lumbar, cervical, etc.)?

This is impossible to answer in the context of the question.
Strength training protocols can mean many different things. Often stronger backs by isotonic testing are the painful backs, not the healthy ones. Similar to the shin muscles, when the back muscles work more than ideal, yes, they become stronger, but also cause pain in a number of ways like spasm, disc herniation or compression, and joint shearing.
Sometimes no strengthening at all is necessary. Often folks just need mobility work in the hips and t-spine to remove the need for the lower back to work overtime to achieve a posture or task.
Again, it would take a proper screen and/or assessment to identify where to start. These blanket suggestions are not appropriate.
Massage is always a good idea, but it only a piece. The good thing is that it is pretty much impossible to hurt someone with good massage or manual therapy. Not only should someone feel good after the technique (not necessarily during), but if the right technique is applied in the right body region, it can be a crucial piece to rehabilitation.

· Massage for bulging disk issues. A friend and running partner of mine has a bulging disk issue. Does anyone know of any research or related articles that would advocate the use of vibration training to help with this?

Again, massage can be immensely valuable for a discogenic issue, but massage without identifying why this person caused their herneated disc is far more important. From this minimal information, if your friend is in pain from this, they should not be running until it is cleared. Running is typically very provocative for musculoskeletal limitations, and issues typically get worse when the “check engine” light comes on.
WBV can be part of the solution if coupled with the appropriate spinal bias. Again this must be determined first. WBV used inappropriately can leave someone limping off the platform worse than how they started.

I hope all of these folks stop dwelling on their “diagnosis” and seek the consultation of a brilliant professional that can shed light on what can be very a confusing and frustrating route of pain and dysfunction. Until that time, the best approach is palliative angles like pharmaceuticals and manual therapy and stopping the activities that hurt.

  • November 1, 2010

Leave a Reply 4 comments

Mark McGrath Reply

Brilliantly written responses to these case studies. Understanding the causes and conditions of serious injury is the only way out of the maze of symptoms. This requires an on-going relationship with a professional who has you functioning optimally as his/her way of conducting business.

Jim Warren Reply

Try long arch supports. A taping technique that starts at the ball of the foot around the heal and back to the ball of the foot. You’ll need an anchor strip around the ball of the foot and be careful not to effect the achilles tendon. Use only 1/2 of the 2″ wide tape. You’ll also need to use stickem to be sure the taping holds up during the workout.

There is also a technique for taping the shin to relieve the splint pain. If you need help with this give me a call. 805-777-0168

Jim Warren

Tristan Sharp Reply

This is was a great post right now I am working my way through “a confusing and frustrating route of pain and dysfunction” after a month of unsuccessful physical therapy for two bulging discs in my lumbar spine. I got smothered by the blanket approach and just had a protocol of exercises thrown at me, albeit they were the basic Mcgill spinal stability set. From my experience some physical therapists just use a pre prescribed set of exercises and stretches for certain problems and do little actual screening, assessment, or tailoring for the individual patient.

Charlie Reply

Tristan – I’m sorry to say that most physical therapists just suck.

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