Q: How can I spot shin splints in clients, and how can I work with them?
A: Shin splints, or traction periostitis, presents as pain and tenderness along the medial border of the tibia, decreases with a warm up and reoccurs after exercise. Clients may feel pain in the shins at night, or when getting up in the morning, and excessive pronation of the feet may be present.
There are many causes of shin splints, which include:
- excessive training
- poor biomechanics
- reduced bone density due to decreased estrogen levels in women
- overuse of the tibialis posterior, causing pain medially (medical tibial syndrome)
- overuse of the tibialis anterior, causing pain anterolaterally (lateral tibial syndrome)
- the tibialis posterior pulling on the interosseus membrane, causing inflammation/pain (periostitis)
- overuse or functional malalignment
As a Pilates Instructor, you can recommend that a client with shin splints see a doctor or physical therapist who can do a complete biomechanical assessment of the foot and prescribe certain therapies or corrections. When working with a client with shin splints, keep in mind that they should train on alternative days only, with gradual load increases according to the principles of rehabilitation.
Pay special attention to correct biomechanics, and keep exercises low-load or non weight-bearing. Try Footwork with Flex-Band—Matwork, Push Thru with Feet on the Cadillac, and Ankle Exercise on the Stability Chair™ with a light spring load from the STOTT PILATES® repertoire.