Tuesday, February 28, 2012

Shin Splints - MTSS and CECS

"Shin splints" is often used as a general term to describe pain in the front of the lower leg. It is one of the most common injuries of the lower leg, reported by people who participate in sport and exercise1. The pain in the shin area can be the result of any one of a number of things but two common causes are as follows:

Medial Tibial Stress Syndrome (MTSS)

Medial Tibial Stress Syndrome - Treatment for Shin Splints[More on Medial Tibial Stress Syndrom - Wikipedia] This condition can range from mild irritation of the external layer of the bone (the periosteum) to a shin bone (tibia) stress. Forces acting on the tibia, as the athlete's foot lands on the floor during activity, cause stress to both the bone and the surrounding soft tissue in the lower leg. Over time, especially if the activity is increased, this stress can lead to pain around the shin.

Chronic Exertional Compartment Syndrome (CECS)

[More on Compartment Syndrome - Warning: medically graphic content - Wikipedia]
A “compartment” is a muscle, or group of muscles that are held together in a not very stretchy bag (fascia). As the athlete exercises the muscles require extra oxygen, which is delivered in the blood. Extra oxygen means extra blood, therefore more blood is pumped into the compartments. In some cases, if the activity is great enough, the veins cannot remove the blood fast enough and the pressure in the compartment rises. As the fascia does not stretch much this results in everything in the compartment being squashed, including nerves (causing pain) and blood vessels (causing the collapse of some of the smaller veins, thus making the whole thing worse as even less blood can be removed from the compartment). The most common compartment that athletes complain about CECS in is the anterior compartment2, which is the one that runs down the outside of the shin.

Reviews of the research have indicated that there are two main factors which increase the risk of someone getting shin splints; poor biomechanics (alignment, muscle control, gait etc.) and training errors3. Obviously, training levels and intensities can be adapted easily but poor biomechanics can take a very long time to correct. So how can an Active650 Full Calf Support help?

What are Shin Splints? Shin Splints Illustrated in anterior and posterior of shinWell, they can’t correct poor biomechanics but they can help to lessen the effect of poor biomechanics and thus allow training without pain. Research into shin splint prevention is rare but a South African study found that putting cushioned inserts into running shoes could prevent shin pain4. This evidence, together with many published recommendations regarding the return to training following an episode of shin splints, suggests that lessening the impact of the foot striking the ground by providing shock absorption is a vital part of training without shin splints.
Now we’re not suggesting that you fold your Active650 Calf Supports up and slip them into the bottom of your shoe, so lets have a look to see what we know that they can do and how they can help.

Pain in lower leg - Lower leg pain - Shin Splints Firstly, the outstanding support and compression provided by the 300% expansion ratio means that the muscles and tendons are held tight without restricting movement. We know that Active650 supports drastically reduce the vibration and oscillation of the muscles and other soft tissue. As the foot strikes the floor energy is transferred up the leg. An athlete with good biomechanics transfers this energy up the kinetic chain (foot, ankle, lower leg, upper leg, hip, pelvis, spine) efficiently and the energy is dissipated. However, someone with poor biomechanics will not transfer the energy as efficiently and this can result in stresses at any weak point in the chain. If the energy is not being transferred through the lower leg efficiently it may result in excess vibration and oscillation of the muscles and soft tissue of the lower leg, causing stress on the bone and at the points where the muscles attach to the bone. An athlete can increase the efficiency of the kinetic chain, through us of an Active650 Calf Support, and allow the energy to dissipate further up.

Secondly, we know that uniform compression can aid venous return. And we know that when it comes to uniform compression Active650 fabric technology is second to none. Therefore, the build up of compartmental pressure experienced by sufferers of CECS in the lower leg can be lessened, or even prevented by wearing an Active650 Full Calf sleeve.
So if you want to feel the benefits………Active650! Every Muscle, Every Body!

Testimonial of Myles Edwards "Myles Edwards is a freelance journalist born in Aberdeen but delivering stories from Iten, Kenya – the home of world distance running." As a 23 year old 800 metre runner with aspirations of competing at the 2014 Commonwealth Games and beyond, I have had more than my fair share of injuries. Last season was probably my best for many years and this was largely down to an (almost) injury free year. Because of this I booked flights to Kenya for a three month training stint at the end of 2011. Unfortunately with two races to go in the track season I began to experience severe discomfort in my shins. Long story short, it put me out for four months and meant the only training I could do in Kenya was on the bike or in the swimming pool. Very frustrating when everyone around you is running!
Filled with determination I sought out the best ways to overcome this injury which so many people seem to struggle with but cannot find a solution. Whilst I still suffer from a bit of pain, there are three things which have got me back running and allowed me to book a second stint in Kenya which I leave for in two weeks time.
1. Ron Coutts, a physiotherapist in Aberdeen has been unbelievably effective. He got me back running after 1 hour of treatment.
2. Ice baths after each run or session. This reduces the inflammation which is key to managing shin splints. Not enjoyable but who cares if it gets you back doing the sport you love.
3. Active650 Full Calf Sleeve. Simon Sinclair from Active650 got in contact with me during my time in Kenya and tried his utmost to get products that would help me sent out to my place in Iten. Unfortunately customs proved to be an unfairly tough obstacle but a separate batch of products were sent to my home in Aberdeen a week after my return.
From the moment I put the Full Calf Sleeve on I felt supported, comfortable and confident to go out and not only train, but train hard. My lower leg was so much looser and relaxed and I could feel the blood flowing a lot more fluently with the product on. They are so much less restrictive than any other compression product I have tried. As a result of this Calf Sleeve the pain was reduced by at least 50% and since then I have been able to train close to pain free. Kenya beckons and a large thanks must go to the team at Active650. It's simple, it works!
Paul Telford from Facebook I've had shin splints for years which come on just with fast walking. I tried the calf support on one leg so I could compare the results. There was a definite improvement on the leg which had the Active650 support. Highly recommend.

Ben Scott, BSc (hons)
Anatomical Sciences


1) Galbraith M R and Lavallee M E. (2009) Medial Tibial Stress Syndrome: conservative treatment options. Current Reviews of Musculoskeletal Medicine 2;127-133
2) Wilder R P and Sethi S. (2004) Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints. Clinical Sports Medicine 23;55-81
3) Thacker S B, Gilchrist J, Stroup D F, and Kimsey C D. (2002) The prevention of shin splints in sports: a systematic review of the literature. Medicine and Science in Sports and Exercise 34(1);32-40
4) Schwellnus M P, Jordan G, and Noakes T D. (1990) Prevention of common overuse injuries by the use of shock absorbing soles: a prospective study. American Journal of Sports Medicine 18;636-641