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ginger -> "shin splints" (January 16, 2006 4:44:00 PM)
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Case #2 Shaun P. 38 yo. textile worker, 88kgs 182 cms ,occasional runner, recently increased running frequency and distance with a personal trainer. Referred by the trainer with a note heading shin splints please fix.
Initial consult 22/12/05. C/o bilateral medial mid to lower shin area pain, R>L. four weeks of slowly increasing difficulty with running, now stopped running due to near constant pain in shins. No injury in last ten year picture.
No previous HX of shin pain , though had C/o calf tightness R>L on previous occasions, limiting running. Some LBP reported though not at present.
OBS, palpably tender into tib post areas of R>L lower limbs. Pronates slightly , R=L. wears orthotics occasionaly when running , but not at other times, recently removed from shoes as felt to be a contributor to shin pain. ( no improvement with no orthotic )
SIJ function nil R, poor L
Hypomobile painfull to mobs R>L L234, with less at L5. Tight sciatic dura, generally poor flexibility.Poor abdominal strength.
Treatment#1 22/12/05
Mobs R=L L2345 5 mins each, to moderate resolution.
SIJ mobs, bodyweight , 2x30 secs full SIJ movements restored.
Sciatic dural stretches, ballistic. 4x8 in long sitting, pushing head to knees, good response with immediate improvements to dural length .
Self stretch strategy commenced.
instructed to wear orthotics for increasing periods till full time over coming three weeks
Treatment#2 6/1/06 reports able to run 3-5 kms twice since last Rx, with minimal discomfort to shins. Stopped when pain increase noted ( as per instructions).
Rx full SIJ mvts noted. Improved sciatic /hams length noted. Mobs L2345 l=R 5 mins each. Dural stretches as per Rx #1. Now wearing orthtics up to 6 hours daily.
Treatment#3 12/1/06
Able to run 5kms three times weekly with no shin pain, full time orthotics use with no complaints of difficulty.Occasional low back pain after each treatment lasting 24 to 48 hours, not severe.
The important issue here was a combination of Poor / nil SIJ function related to poor use of orthotics and his history of general lumbar stiffness.Along with specific hypomobility and related inflammatory events producing referred pain ( increasing with fatigue) to a L34 distribution.
Discharged after L2345 mobs L=R 2 mins each and suggestions for abdominal exs, stretching etc.
Comments invited
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