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I don't understand how to get rid of posterior shin splints as opposed to anterior shin splints. biomechanics?

Question: I don't understand how to get rid of posterior shin splints as opposed to anterior shin splints. biomechanics?

Ok I understand why you get shin splints in the front of your shin due to anterior tibialis weakness. I do not understand what cause posterior. I've read enough on the syndrome. I don't have flat feet, don't really know if i over pronate. I have had anterior shin splints in the past during my hs years playing basketball and some college. This was mostly due to sprints. Now im jogging alot and training for the military. I haven't sprint in a few months. I have pain above my medial malleolus going up my medial shin. What exercises do i have to do?

Also what are the biomechanics of the posterior tibialis? I understand the anterior aids the foot in dorsiflexion. When your foot dorsiflexes, the anterior tibialis tightens and shortens. What does the posterior do??? Do heel lifts work the posterior tibialis just as much as the anterior? Also do calf raises help both equally? I don't get it

thanks for the help

Answer:

Dear MightyHealthy,

It's been more than 3.5 years since you asked your question, so I hope you are still out there somewhere. I thought it was a good question.

Each running injury I treat, I make into a story. The story has to have a victim and a villian. Usually the part that hurts is the victim. Sometimes you have to look a long time to find the villian.

It helps to know what the victim's occupation is. So here's what I've found out about what the posterior tib does. Sit in a chair, hips, knees, and ankles flexed at 90 degrees, and toes pointed straight forward, in such a way that you can easily bend over and grab your feet. Press on the posterior tib where it hurts (ie a few cm above the medial malleolus). Now, supinate your foot--keep the heel on the ground, roll the foot toward the outside so that the lateral border of the foot and the little toe stay on the ground, the big toe comes off the ground, and all the toes point somewhat medially instead of pointing straight ahead.

The muscle that causes this motion is the posterior tib. You should be able to palpate the working muscle under your fingers. If you've got any kind of PTSS going on, pressing the sore area while performing the above movement will be joyously painful.

So that's what the posterior tib does. Its action as a supinator provides a clue that the injury might occur because it is being asked to control pronation (which requires it to act eccentrically, which is hard on a muscle). So, the search for the villian might follow the inquiry, why might excessive pronation be occuring? Is it a weak gluteus medius? Overactive TFL? Or something more local, such as weak anterior tibs, or really tight soleus/gastrocnemius. A recent case was apparently due to a tight/dysfunctional iliacus, and cleared up by itself when the iliacus was treated. What a wonderful contraption is the body!

Good luck out there--

Jim Reardon

Answer:

What a great answer - thanks Jim - and I'm sure it will be useful to other sufferers of shin splints.