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Sports Surgery Clinic:Layout 1 ask the to the outside of your kneecap and shin physio bone at the outside of your knee. The ITB is under most stress when the knee is bent and the thigh rotates inwards. It Q&A usually only hurts when the knee is moving through a particular angle and is often worse when running downhill. Physiotherapist Orla Crosse of the Causes: the underlying causes of pain Sports Surgery Clinic explains how to with ITBS are varied but tend to have a few common threads between patients. deal with two of the most common Overuse and inflexibility can shorten the ITB. Also, ITB length is influenced by our and problematic running injuries: shin leg biomechanics or ‘hip – knee – foot’ spints and Iliotibal band syndrome. alignment. Runners who develop ITB pain may overpronate, have a leg length Two of the most common running-related of your leg (calf) and the front (tibialis discrepancy, and suffer from weak hip injuries I see in the clinic, and indeed in my anterior). abductor or gluteal muscles. When the own running group, are shin splints and There is one common biomechanical flaw ITB reaches the knee it becomes narrow Iliotibal band syndrome. If you have a race or I find with the majority of shin splints and friction can occur between it and the event coming up they can put a serious wall patients and that’s tight calf muscles. Your underlying bone; this causes in front of you, bringing you to a painful stop calf helps push you off the ground when inflammation, thickening and pain. each time you put on your runners. walking/running, in other words it points Women are more likely to experience Frustration! I’ve heard it all, from ‘try golf your toes away from you. ITB symptoms due to the nature of our ball massage’ to ‘change runners frequently’ In front, your tibialis anterior pulls your hip position. Our wider hips mean the ITB and ‘regular deep tissue massage on the foot up from the ground, pointing your toes can already be stretched and shin bone’. up towards the ceiling. If your calves are compromised before we even start to run. The good news, though, is that you can tight it will be difficult to pull your foot up Track running can leave people control many variables that cause these from the ground due to the lack of flexibility susceptible to developing this problem issues, you can change the situation. Such in the back of your leg. Your tibialis anterior due to different forces loading through overuse conditions are usually affected by has to work extra hard to pull your foot up each leg. your running biomechanics (how you run), during running due to this pesky tight calf leg strength and flexibility. and - lo and behold - you suffer an overuse Treatment: as always, prevention is better Research has shown that many common injury. than cure. If you think you have ITB pain, running injuries such as ITB symptoms and rest from running, reduce mileage, or shin splints could have been prevented if Treatment: decrease your mileage. Take the better still, do no miles at all. Ice the area deficits had been identified and addressed load off! Consider cross-training. Stretch for 10-15 minutes after a run if it is earlier. Sports physiotherapists can identify your calf muscle and Achilles tendons acutely sore. Check that you’re not in advance whether physical limitations or regularly; I recommend stretching twice wearing old runners. deficits exist which may lead to or delay the daily for 1-2 minutes and over a period of To address the imbalances that caused recovery of current injuries. time they will loosen up, which will take the the problem in the first place, it is best to stress away from your shins. be assessed by a chartered Shin Splints Foam rollers are an excellent way to physiotherapist who can tailor your This term relates to pain below the knee in release tight or dense areas within the calf return-to-run programme and also the front of the shins. Most of us have muscle; 4 -5 minutes once a day is provide treatment to the affected area. experienced a pain along the front of our recommended by most. When you begin to Whether or not you can effectively shins either during or after a run at some pick up your mileage again, do so gradually stretch and lengthen your ITB is point. - no more than 10% per week. Check your debatable. You can have a definite effect Seasoned runners may be affected when runners; ensure they are supporting you on your hip-knee-foot alignment. Gluteus breaking in new runners or changing where you need support. strength exercises may be required, such running surface, lasting for a day or so. A word of warning – shin pain doesn’t as lateral step-ups, single leg squats and Sometimes it crops up when you haven’t always mean you have shin splints. Stress side leg lifts. This will help stabilise your been running for a while and head out on a fractures and compartment syndrome will hips and pelvis, which will have a positive long run. manifest like shin splints pain. They require effect on your biomechanics. For others it can be more persistent and different investigations to aid diagnosis and Foam rolling the side of your thigh is an debilitating. Think a sharp stabbing pain in will need different treatment. effective way to release tight underlying the front of the shins, worsened by heel If you notice redness, swelling, heat and muscle and may help to reduce strike when running. It lasts for the duration sharp, severe pain when pressing on your thickening in the connective tissue. It is of the the run and can be quite stiff and shin, I recommend seeing a chartered important not to foam roll the side of your sore after the run and well into the next day. physiotherapist before commencing any knee – this can lead to further It settles when you rest, but even after a few self-rehabilitation. complications. weeks’ rest, you run again and it’s back! If you’re track running, change Iliotibial Band Syndrome direction every few laps to prevent an Causes: shin splints are caused by many This is an umbrella term for knee pain that imbalance developing. Improving the issues which a chartered physiotherapist can present on the outside of your knee. It is biomechanics can make a dramatic can discuss with you. Overpronation, worn a stubborn and nagging injury and usually difference, which will cross over to your shoes, an inadequate stretching regime or occurs after an amount of mileage has built performance, resulting in less pain and running continuously on a deviated surface up, but can also affect those new to improved running time and distances. (Irish country roads!) are influential factors. running. The ITB is a long fibrous band that As always, if you have any further queries, True shins splints often occur because of an extends from your hip/gluteus muscles, runs seek professional advice from your imbalance between the muscles at the back down the outside of your thigh and attaches chartered physiotherapist. 28 Irish Runner.
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