Acupuncture for Shin Splints (Runner’s We’re Looking at You)
As we move out of winter and into the glorious warm days of spring, many athletes are transitioning from treadmills and indoor tracks to the winding, mountainous trails as they melt out from being covered in winter’s snow. With this change in venue, elevation and surface can come shin splints, knee pain, hip pain, among other aches and pains. Shin splints (medial or anterior tibial stress syndrome), can affect a variety of athletes from runner’s to hikers to soccer players. Generally they come on gradually as an overuse injury when there is a change in intensity of activity, terrain, duration, etc. Pain will be one of two places: On the outside of the tibia (shin bone) or on the inside. The pain will often run down down along the bone for a few inches. If the pain on the inside is not hugged up against the bone, we will need to differentiate whether or not it is true shin splints or a soleus strain.
Shin splints can be debilitating for many athletes especially when even small amounts of the running can aggravate the condition, making training a painful and stressful situation. As the condition progresses, it results in inflammation and micro-tears of the connective tissue of tibialis anterior or tibialis posterior away from the bone. Shin splints can sometimes progress to changes to the bone if stress on the area continues unaddressed.
Sometimes, shin splints can be associated with pes planis, in which the medial arch of the foot collapses causing foot overpronation. Pronation is a natural and normal part of the gait as the arches of the foot absorb load during gait transferring force through the forefoot in gait. If the medial arch is collapsed or overpronated, then the connective tissue of the foot cannot absorb and rebound during gait leading to a change in mechanics not only of the foot but in muscles and connective tissue up through to the knee or hip.
Acupuncture can help address shin splints in a variety of ways. The selection of certain acupuncture points and the treatment of affected channels can help decrease pain, inflammation, and the stressor’s reaction to the tissue. As the injury starts, sharp pain in the injured tissues is seen as a qi and blood stagnation. Some people will experience dull pain at rest; this is seen as an underlying liver blood deficiency and will often be accompanied by easily fatigued muscles among other symptoms.
In addition, acupuncture along with strengthening exercises can help increase proprioception and start to make changes to foot mechanics that might be contributing to the issue. Most recoveries will do best with a short-term pause in the exacerbating activity. Subbing in cycling for running is a good place to start since it will keep cardiovascular fitness up along with leg strength while decreasing the stress to the injured area. Typically a series of treatments along with exercises will have the best results. Many patients see changes in a couple of weeks with twice weekly appointments. By 5-7 weeks many patients will be able to return to their sport, however everyone is different. Depending on activity levels, length of time the injury has been going on and how people respond to treatments can affect outcomes.
Resources:
Callison M, Schreiber A, Ryan NT, Livermore M, Scoggins A. Sports Medicine Acupuncture : An Integrated Approach Combining Sports Medicine and Traditional Chinese Medicine. San Diego, Calif. Acusport Education; 2019.