Shin Splints / Tibialis Posterior pain

by Lance Carter

Recently, I’ve helped several customers experiencing pain in their Tibialis Posterior muscle, which is commonly known as “shin splints.” The term shin splints covers a variety of specific pain locations.  Anterior shin splints involve pain and inflammation on the front and outer side of the shin in the Tibialis Anterior muscle, while posterior shin splints affect the inner side of the shin in the Tibialis Posterior muscle. Many years ago, when I did massage therapy, I worked on endurance athletes frequently; pain in the Tibialis Posterior was common.  The muscle responds extremely well to massage. It’s also a muscle that is very easy to release with self-massage.

 Simply sit in a chair, cross the sore leg over the knee of your other leg. Throw a little massage oil, olive oil, or lotion on your leg.  Using your thumb (of the arm on the opposite side as your sore Tibilias Posterior) begin towards your ankle and on the medial (inside, toward body’s midline) side of your Tibia.  Slowly and gently slide your thumb up your Tibia moving towards your knee.  You’ll know when you’ve hit the sore location.  Hang out there rubbing the muscle in tiny circular motions until the pain lessens.

Pain in the tibialis posterior muscle and tendon, often from running, is usually caused by tibialis posterior tendinopathy (also known as posterior tibial tendonitis). This condition develops from overuse or overpronation (excessive inward rolling of the foot) and can cause pain along the inside of the ankle and foot, particularly during or after activities like running. 

Symptoms:

  • Pain and tenderness along the Tibialis Posterior tendon, which runs from the back of the ankle, across the inside of the foot, and into the arch.

  • Pain may be worse during or after running, walking, or climbing stairs.

  • Swelling along the tendon, especially around the inner ankle.

  • Tenderness to the touch, especially when the foot is flexed.

  • Weakness in the foot or ankle, especially when pushing off.

 

Causes:

  • Overuse:

Repetitive strain from running, especially with sudden increases in mileage or intensity. 

  • Overpronation:

Excessive inward rolling of the foot during running, which puts extra stress on the tendon. 

  • Footwear:

Poorly supportive or worn-out shoes can contribute to overpronation and tendon strain. 

  • Muscle imbalances:

Weakness or imbalances in the muscles of the leg and foot can affect how the tibialis posterior tendon functions. 

  • Poor biomechanics:

Issues with the way the foot moves during running can also lead to increased stress on the tendon. 

Treatment:

  • Rest: Reduce or stop activities that aggravate the pain, such as running. 

  • Ice: Apply ice packs to the affected area for 15-20 minutes at a time, several times a day, especially after activity. 

  • Compression: Use a compression sleeve or bandage to help reduce swelling. 

  • Elevation: Elevate the foot to help reduce swelling. 

  • Supportive shoes/orthotics: Consider shoes with good arch support or use custom or over-the-counter orthotics to help control overpronation. 

  • Stretching and strengthening: Exercises to improve flexibility and strength in the Tibialis Posterior muscle and surrounding muscles can help prevent future problems. 

  • Physical therapy: A physical therapist can assess your condition, provide specific exercises and treatment recommendations, and guide your return to running. 

Super Jock ‘n Jill has partnered with many of the local Physical Therapists in the region to provide free medical consultations.  Tuesday and Thursday nights at 6:15 Physical Therapists donate their time to help our customers.  No appointment necessary.  Customers are served on a first come, first served basis.  Click here for a list of PT’s and dates throughout the year.

For more blogs from Lance, check out his Substack.

Judy Albrecht