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Would you like to know what Ron was thinking during his Saturday morning coffee? Check out his blog below, as he shares some thoughts!
The last patient of my week, on last Friday, was a 19 year old young man that was referred to me for anterior shin pain and chronic shin “splints”. He had a history of back pain and is a runner and was an avid hockey player. He reports when he doesn’t do anything, his anterior shin pain does not bother him. He has been to every specialist possible for this type of problem, except by someone who has taken a PRI course or is trained or certified in PRI.
The first thing I read in my Saturday local paper, over a cup of coffee, was an article written by a physician and professor at Harvard Medical School. “Give shin splints time to heal” was the title of the article. Needless to say, after reading the article, I had a hard time finishing my coffee, and I could feel my body begin to “splint”. The physician reported that shin splints develop because of overuse of the posterior tibialis muscle in the lower leg near the shin. He did mention that shin splints can be caused by tibial stress fractures. His advice; rest, ice, compress, elevate and non-steroidal anti-inflammatory drugs. As the pain gradually goes away, start with a walking program. Accordingly, if you return to your training too early or too intense your shin splint may come back. He goes on to talk about the need for warm ups, to use the 10 percent rule or not to increase time or intensity of your workouts more than 10 percent per week, and to strengthen the muscles around you “lower” legs and ankles. In his opinion, “Many great runners have experienced shin splints, rested the muscle and gone on to glory.” This syndicate writer did not mention what a shoe orthotic, a good supportive shoe, a biomechanical oriented program for the upper leg including the pelvis and hips, or a myokinematic program for transverse plane stability at the femur or calcaneus might do for this “splint” pain.
The word “splint” according to Webster, means ‘a rigid device used to prevent motion of a joint or the ends of a fractured bone’. When one is splinting they are in a feed forward process. Pain does not allow one to relax and therefore makes one ‘splint’. The pain, may subside if they do nothing. However, that does not address the neurologic feed forward system issues because the dysfunctional torsion on the bone has not been addressed.
My Friday afternoon patient did well with a PRI approach and actually could alter his shin splint pain after his left AIC, right BC and right TMCC patterns were considered. The torsion on his tibial bone appeared to be coming from a right forward shoulder and the lack of a left posterior mediastinum, an extended postural pattern that was reinforced by a former head injury, and a deep lordotic back (40 to 50 degrees of straight leg raise). He felt his shin “splints” come and go in the clinic when he learned how to move over his left hip properly, flex his thorax and lumbar spine correctly with ambulation and visually see and feel the ground in front of him, appropriately.
My Monday morning cup of coffee was more enjoyable, only because this message allowed me to splint a little less. Thank you.