Shin Splints

What are Shin Splints?

Shin Splints are the common name for a condition in which the muscles on top of the shin bones – the tibia and the fibula, become tight and as a result cause pain.

It mostly occurs after an increase in activity – either frequency, length or intensity, and can last for an undetermined amount of time depending on various factors such as exercise, rest and strength.

Medial Tibial Stress Syndrome:

Medically, shin splints are referred to as Medial Tibial Stress Syndrome (MTSS). It is caused by overuse and is commonly seen in athletes and military personnel. The cause of MTSS is not known however many factors can cause it including overtraining, poor unsupportive footwear, ankle muscle imbalance, tight triceps surae muscles (calf/soleus) and your back being out of balance.

Typically MTSS presents with a diffuse (wide spread) palpable pain worse after exercise – it is more common in females than males. The pain is usually described as a dull ache that gets better with rest. One reason MTSS is so painful is due to periostitis – the inflammation of the periosteum (covering of the bone) where the muscle attaches.

Specific movements that may cause pain is knee extension – that is the straightening of the leg, as this activated the muscles affected. Inflammation of the Achilles tendon (Achilles tendonitis), the bursa on the back of the heel (retrocalcaneal bursitis), plantar fasciitis (irritation of the plantar fascia), medial arch discomfort, calf pain and cramping, iliotibial band syndrome and Osgood Schlatter’s can also occur at the same time as MTSS.

One of the risks of having MTSS repeatedly or long term is a stress fracture. Signs this has occurred is when pain occurs after activity has finished into cooldown and daily activities. Another sign is when the pain becomes less wide spread and more specific to the inside of the tibia (shin bone) and the from halfway up the shin down after exercise. Imaging such as x-ray and magnetic resonance imaging (MRI) can be used to detect other sources of pain as well as stress fractures.

Treatment:

Treatment of MTSS varies depending on therapist and sport. In the acute, short-term treatment use of compression stockings, anti-inflammatories, rest and either ice or heat depending on the varied evidence. Kinesiology taping uses tape that aims to relieve pain, facilitate proprioception, change muscle activation and correct abnormal movement patterns.

Long term orthotics (inserts) and supportive shoes can be used to try and correct the posture of the foot. Increasing the supination (weight on the outside of the foot), strength of the inverter/evertor muscles and releasing the muscles on the bottom of the foot can also be helpful. Supplements such as vitamin D, calcium for bone health/density and magnesium for muscle fatigue should be taken long term as preventatives.

Manual therapy, such as osteopathy can be beneficial in both the short and long term phases of shin splints/MTSS. Through various techniques such as soft tissue, myofascial release, mobilisation and manipulation treatment is aimed at decreasing muscle tension, improving joint mobility and releasing the fascia of the foot and lower leg.

References

Bhusari, N. and Deshmukh, M. Shin splint: a review. Cereus, 15 (1), e33905. https://doi.org/10.7759/cureus.33905

Guo, S., Lui, P. (2022). Efficacy of Kinesiology taping on the management of shin splints: a systematic review. The physician and sports medicine 50 (5), 369-377. https://doi.org/10.1080/00913847.2021.1949253

Schulze, C. Finze, S., Bader, R., Lison, A. (2014). Treatment of medial tibial stress syndrome according to the fascial distortion model: a prospective case control study. The Scientific World Journal, 790626. https://doi.org/10.1155/2014/790626


Yüksel, O., Ozgürbüz, C., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Ertat, A. (2011). Inversion/eversion strength dysbalance in patients with medial tibial stress syndrome. Journal of sports science & medicine 10 (4), 737-742. Inversion/Eversion strength dysbalance in patients with medial tibial stress syndrome – PubMed (nih.gov)

Ozgürbüz, C., Yüksel, O., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Karamizrak, O. (2011). Tibial bone density in athletes with medial tibial stress syndrome: a controlled study. Journal of sports science & medicine 10 (4), 743-747. Tibial bone density in athletes with medial tibial stress syndrome: a controlled study – PubMed (nih.gov)

 

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Baker’s Cyst

What are Baker’s Cysts:

Also called popliteal cysts, baker’s cysts occur behind the knee in the popliteal fossa and are fluid filled sacs. They are predominantly asymptomatic and usually discovered during imaging for another unrelated condition.

Symptoms associated with these cysts include knee pain, tightness, and discomfort. Pain worsens with increased activity and decreases range of motion. Inflammation is most visible when the knee is at full extension and least visible at 45 degree flexion.

Lower limb swelling can occur due to the cyst’s impingement of blood vessels and in some cases may present the same as deep vein thrombosis. If the cyst bursts it can cause inflammation/swelling, sharp knee/calf pain and a sensation of water running down the calf. When the cyst busts it can cause nerve entrapment, blood vessel blockage and compartment syndrome.

It is typically diagnosed through physical examination and imaging such as plain radiography, ultrasound and MRI.

Causes:

The knee is a synovial joint where a capsule of synovial fluid cushions between the two bones. Bakers’ cysts can occur when this synovial fluid accumulates and moves between muscle attachments to the knee. This is due to the pressure gradient between the knee joint capsule and fossa moving fluid flow into the fossa.

While more common in adults they can also occur in children. However rather than being caused by a co-morbidity they typically occur when the knee joint capsule herniates.

Commonly occurring in patients aged 35 to 70 years of age or in children 4 to 7 years of age.

Inflammation of the semimembranosus (hamstring) bursa can also cause fluid build up in addition to arthritis, meniscus damage and other degenerative conditions.

Risk factors:

Patients that have a history of trauma to the knee cartilage and meniscus are at greater risk of developing a baker’s cyst. In addition, they commonly occur when patients have degenerative conditions such as arthritis.

 

Treatment:

If the cyst is asymptomatic and is discovered by accident during imaging or another condition no treatment is typically performed.

Conservative treatment involves behaviour modification such as decreasing aggravating activity and taking anti-inflammatories/pain relief.

In children conservative treatment of the cyst is preferred if the site is not painful and the size of the cyst is less than 3 cm. If the cyst is larger than this and presents with pain surgical excision is considered.

Aspiration (drainage) of the cyst can be performed in which a needle is placed through the posterior leg at the popliteal fossa and into the baker’s cyst. From there a syringe is used – this procedure is performed under ultrasound guidance. Corticosteroid injections into the baker’s cyst aiming to decrease the size of the cyst and relieve pain can also be performed. Risks with these interventions include pain, bleeding, infection, tissue damage and cyst recurrence.

Surgical intervention includes arthroscopy where the degenerative tissue is removed. Complete excision of the cyst can also be performed however this is not recommended in patients that have developed the cyst secondary to degenerative conditions.

Our Osteopaths have found that patients report increased range of motion and improved function after treatment.

 

 

References:

Al Khateeb, A. (2024). Bakers Cyst. Baker cyst | Radiology Case | Radiopaedia.org

Fredericksen, K., & Kiel, J. (2021). Bedside ultrasound-guided aspiration and corticosteroid injection of a baker’s cyst in a patient with osteoarthritis and recurrent knee pain. Journal of the American College of Emergency Physicians Open, 2(2), e12424. https://doi.org/10.1002/emp2.12424

Leib, A. D., Roshan, A., Foris, L. A., & Varacallo, M. (2020). Baker’s Cyst. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430774/

Mansour, M. A., Shehata, M. A., Shalaby, M. M., Arafa, M. A., & Almetaher, H. A. (2021). Baker’s cyst in children: conservative management versus surgical excision according to clinical and imaging criteria. Annals of Pediatric Surgery, 17(1). https://doi.org/10.1186/s43159-021-00071-1

‌Nanduri, A., Stead, T. S., Kupsaw, G. E., DeLeon, J., & Ganti, L. (2021). Baker’s Cyst. Cureus, 13(12). https://doi.org/10.7759/cureus.20403

Patel, C. (29 August 2012). Baker’s Cyst. Baker’s cyst – wikidoc

Van Nest, D. S., Tjoumakaris, F. P., Smith, B. J., Beatty, T. M., & Freedman, K. B. (2020). Popliteal Cysts: A Systematic Review of Nonoperative and Operative Treatment. JBJS Reviews, 8(3), e0139. https://doi.org/10.2106/JBJS.RVW.19.00139

 

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How to Stop Aching Pains at Night

How to Stop Aching Pains at Night

How to Stop Aching Pains at Night: A Guide to Osteopathy

Do you find yourself tossing and turning at night due to aching pains in your body? If so, you are not alone. Many people suffer from night time aches and pains that can disrupt their sleep and negatively impact their daily lives. But fear not, there are ways to alleviate these aches and pains, and one effective method is through osteopathy.

What is Osteopathy?

Osteopathy is a holistic approach to healthcare that focuses on the relationship between the body’s structure and function. Osteopaths believe that the body has what it needs to heal itself, improving function assists it to be able to heal itself and prevent illness. Osteopathy uses manual therapy techniques such as stretching, massage, and manipulation to improve the body’s overall function and alleviate pain.

Common Causes of Aching Pains at Night

There are many reasons why you may be experiencing aching pains at night. Some common causes include:

  • Poor posture: Sitting or standing in a certain position for long periods of time can put strain on your muscles and joints, leading to discomfort and pain.
  • Injuries: Previous injuries or trauma can cause lingering pain that worsens at night when the body is resting.
  • Stress: Mental stress can manifest as physical pain, particularly in the muscles and joints.
  • Medical conditions: Conditions such as arthritis, fibromyalgia, or sciatica can cause nighttime pain and discomfort.

How Osteopathy Can Help

Osteopathy can be a highly beneficial treatment for alleviating nighttime aches and pains. Osteopaths assess the body as a whole and look for areas of tension, strain, or misalignment that may be contributing to your pain. By using manual therapy techniques, osteopaths can help release tension in the muscles, improve joint mobility, and promote overall healing.

Some of the ways that osteopathy can help with night time pain include:

  • Improved circulation: Osteopathic techniques can help improve blood flow to areas of the body that may be experiencing pain, promoting healing and reducing discomfort.
  • Reduced muscle tension: Manual therapy can help release tight muscles that may be causing pain or discomfort, allowing for greater relaxation and better sleep.
  • Improved joint mobility: Osteopathy can help improve the function of the joints, reducing stiffness and pain that may be worsened at night.

Self-Care Tips for Managing Nighttime Aches and Pains

In addition to seeking treatment from an osteopath, there are several self-care tips that can help you manage nighttime aches and pains:

  • Practice good sleep hygiene: Make sure your sleep environment is comfortable and conducive to restful sleep. This includes using a supportive mattress and pillows, keeping the room cool and dark, and limiting screen time before bed.
  • Stretch before bed: Gentle stretching before bedtime can help relax tight muscles and prepare your body for sleep. Focus on areas that are particularly tense or painful.
  • Stay active: Regular exercise can help reduce muscle tension and improve overall body function. Try incorporating gentle exercises such as yoga or Pilates into your routine.
  • Practice relaxation techniques: Stress and anxiety can exacerbate nighttime pain. Try practicing relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation to help calm the mind and body before bed.

Consulting with an Osteopath

If you are experiencing persistent nighttime aches and pains that are impacting your quality of life, it may be beneficial to consult with an osteopath. Osteopathy is a natural treatment option that can help address the root cause of your pain and provide effective relief.

During your initial consultation, your osteopath will conduct a thorough assessment of your condition, including a review of your medical history and a physical examination. Based on their findings, they will develop a personalized treatment plan that may include manual therapy techniques, exercise recommendations, and lifestyle modifications to help alleviate your pain. The will also assess if there is another underlying cause that may need a medical diagnosis and refer you if needed.

By working with an osteopath, you can take proactive steps to address your nighttime aches and pains and improve your overall well-being. Don’t let pain keep you up at night – seek out osteopathic care and start experiencing relief today.

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What is Plantar Fasciitis? How Can an Osteopath Help?

What is Plantar Fasciitis?

Plantar fasciitis is a common condition that causes pain in the heel and bottom of the foot. It occurs when the plantar fascia, a thick band of tissue that connects the heel to the toes, becomes inflamed or irritated.

This condition is often characterized by a stabbing pain in the morning when you take your first steps, which may ease up as you move around. However, the pain can worsen after long periods of standing or physical activity.

Plantar fasciitis can affect anyone, but it is more prevalent in runners, people who are overweight, or individuals who spend prolonged periods on their feet.

Main Causes of Plantar Fasciitis

While the exact cause of plantar fasciitis is unknown, several factors can increase the risk of developing this condition:

  1. Tight or Weak Muscles: Muscles in the feet, calves, and the Achilles tendon may become tight or weak, placing additional stress on the plantar fascia.
  2. Overuse: Engaging in activities that involve repetitive stress on the feet, such as long-distance running or ballet, can strain the plantar fascia.
  3. Poor Foot Mechanics: Certain foot issues, including flat feet, high arches, or an abnormal walking or running pattern, can contribute to the development of plantar fasciitis.
  4. Inappropriate Footwear: Wearing shoes with poor arch support, inadequate cushioning, or an improper fit can place excessive pressure on the plantar fascia.
  5. Age and Weight: Plantar fasciitis is more common in individuals between the ages of 40 and 60. Excess weight can increase the stress on the plantar fascia.

How Osteopathy Can Help

Osteopathy is a holistic approach to healthcare that focuses on treating musculoskeletal disorders and optimizing the body’s natural ability to heal. It can be a valuable treatment option for individuals suffering from plantar fasciitis.

Osteopathic treatments for plantar fasciitis often involve:

  1. Soft Tissue Massage: Osteopaths use specialized massage techniques to stretch and relax the tight muscles in the feet and calves. This helps to alleviate tension and reduce strain on the plantar fascia.
  2. Mobilization: Gentle joint mobilization techniques may be employed to improve the movement and flexibility of the affected foot, ankle, and leg. This can help to relieve pain and restore normal function.
  3. Orthotic Devices: Osteopaths may recommend or prescribe customized orthotic devices, such as shoe inserts or heel cups. These devices provide proper support and alignment to the foot, reducing stress on the plantar fascia.
  4. Exercise Prescription: A comprehensive exercise program tailored to the individual’s condition and needs can be provided. These exercises often focus on stretching and strengthening the muscles and tendons surrounding the foot and ankle.
  5. Postural Assessment and Correction: Osteopaths assess the overall posture and body mechanics of the patient to identify any underlying issues that may be contributing to plantar fasciitis. They can then provide guidance on correcting these imbalances to reduce strain on the affected area.
  6. Education and Lifestyle Advice: Osteopaths provide valuable education regarding proper footwear, activity modification, and lifestyle changes that can help prevent future episodes of plantar fasciitis.

Osteopathy aims to address the root causes of plantar fasciitis, rather than just managing the symptoms. By promoting balance and restoring optimal function to the musculoskeletal system, it can provide long-term relief and improve overall well-being.

If you are experiencing the discomfort of plantar fasciitis, consider consulting an osteopath who can provide personalized treatment and advice to help you recover and regain your quality of life.