Understanding its network and the underlying issues
Between the knee and ankle joint lies two distinctive bones, the fibula and tibia. Better yet known as the shin of our body’s lower leg. There are four compartments surrounding the shin with dense fascia, muscles and nerves.
Let’s begin with the exploration of the anterior compartment. This area contains the tibialis anterior, extensor digitorum and extensor hallucis longus muscles. Injury to these muscles is a result of chronic overuse. Postures that favour chronic shortening during driving a sharply angled gas pedal or sudden tripping with the ankle forced into plantarflexion can strain the muscles of the anterior compartment. Abruptly increasing training intensity that involves jumping or running on a hard surface, may also stress the anterior compartment muscles.
The superficial posterior compartment contains the gastrocnemius and soleus, more intrinsic than the superficial posterior compartment is the deep posterior compartment which contains the tibialis posterior, flexor digitorum longus and flexor hallucis longus muscles. 2021 will always be remembered as the year of adjusting and rebuilding after the pandemic struck countless of people’s social lives. We spent hours working from home during lockdowns. Having to sit more causes the posterior compartment muscles to shorten easily. Most notably, with bad chair sitting height ergonomics and their feet not touching the ground evenly during sitting is prone to cause calf tightness.
The superficial and deep posterior compartment muscles tend to shorten for women that wear high heels often, people sleeping with their ankles plantar flexed in a supine position, or walking or running uphill. If it’s left untreated it can lead to cramps including nocturnal cramps and compensation issues such as inability to straighten knee if the ankle is dorsiflex. In addition to trigger points and tightness being present at the posterior compartment of the shin, those issues may disguise itself in a form of heel pain and during assessment, there will be some signs of loss in active ankle dorsiflexion.
Research has also shown that the lack of ankle dorsiflexion, not rehabilitated properly, can cause the knee joint to overload and lead to injury during gait walking, hence adequate resting length to these posterior compartment muscles and ankle joint range of motion is important, especially in sports that require running and jumping. Once treated, the patient should be taught to jump and land correctly too. The toes should be the last point to leave the floor in a jump and the first to contact the floor on landing. Toe contact is followed by progressive lowering through the foot, with the knee and hip flexing as the heel touches the floor will minimize shock.
Peroneal longus and brevis muscles emerge as the lateral compartment of the shin, which is the 4th and last compartment surrounding the shin. As for the type of shin pain discussed here, it rarely affects the lateral compartment muscles. This compartment is more commonly affected due to ankle sprains.
Bioelectric Meridian Therapy (BMT) and Shin Splints
There’s no denying the BMT modality’s prowess is growing in the area of rehabilitation. With increasingly more studies done for shin splints which is basically persistent pain occurring between the knee and ankle. It has a number of names include Chronic Exertional Compartment Syndrome (CECS), Exercise Induced Leg Pain (EILP), Biomechanical Overload Syndrome (BOS), Exertional Lower Limb Pain (ELLP), and BMT’s therapeutic effects help by promoting blood circulation, reducing ischemia of the affected compartment. The treatment for shin splints using BMT, whether acute or chronic, aims to relax the stressor shorten muscles and improve its lymphatic drainage.
Other management strategies include: kinesio taping, stretching exercises, strengthening exercises, the use of proper exercise footwear, and running and jumping re-education techniques all used along with BMT will unlock endless positive outcomes in recovery.
Nelson,
BMT practitioner
References
Dudziński, K., Mulsson, M. and Cabak, A., 2013. The effect of limitation in ankle dorsiflexion on knee joint function. A pilot study. Ortopedia Traumatologia Rehabilitacja, 15(2), pp.1-10.
Norris, C., (2018) Sports and Soft Tissue Injuries: A Guide for Students and Therapists. 5th edn. 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN. Routledge. International Journal of Medical and Exercise Science. Vol 1(1), 16-21.
Mandom, S., Paul, J., (2015) Effectiveness Of Stretching And Modified Footwear On Reducing Pain And Functional Ability In Athletes Suffering From Shin Splints.
