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shin splints and TTS

Posted by Freddie S on 5/15/03 at 23:12 (118932)


I read and article in a book tonight where a doctor talked about a patient he was treating for shin splints and they exhausted every measure and then discovered the patients problem was TTS. I am a flat footed runner and have been trying to be a runner now for 4 years. I have had medial shin spints for 4 years now. I have also been flat footed since birth. I have custom orthotics but they do not help and I really do not like them anyways. I have tried all sort of shoes and the medial shin splints are there wether I am wearing a motion control shoe or a cushion shoe. I also have a tingling feeling in my left foots heel sometimes and it hurts to flex that foots big toe downwards. When that toe is flexed downwards I can feel the pain in the arch area and the heel. Do you think that my doctors have overlooked this? Do you think maybe that I have TTS? Thanks so much this is my last resort at an attempt to get rid of this medial shin pain when running.

Freddie S

Re: shin splints and TTS

Ed Davis, DPM on 5/15/03 at 23:23 (118934)

TTS and shin splints are very different diagnoses -- not things that would be mistaken for the other. There are medial (or posterior) shin splints (tibialis posterior), anterior shin splints (tibialis anterior) and lateral shin splints (peroneals). Did your doc tell you which type you have?

Re: shin splints and TTS

Ed Davis, DPM on 5/15/03 at 23:29 (118935)

After re-reading your post, you did say the shin splints were medial. Tibialis posterior starts in the deep posterior compartment of the leg, goes around the inside of the ankle bone and inserts into the arch. It is the tendon reponsible for inverting (lifting up on the arch) the foot. Orthotics should help --- they may need to be checked to make sure they were made correctly.

If the tibialis posterior tendon stays swollen for long periods of time, it can place pressure on the post. tib. nerve causing TTS like symptoms -- that may be what you were thinking of.

Treatment for posterior (medial) shin splints includes physical therapy, orthotics, motion control shoes.

Re: shin splints and TTS

Dr. David S. Wander on 5/16/03 at 08:21 (118947)

I agree with Dr. Davis. 'Shin splints' are actually a generalized, non specific term. A shin splint is actually a partial tearing of the area of interface between the muscle and it's attachment to the bone. In SEVERE cases that have not responded to conservative care over many years, surgical intervention can be performed which partially releases this interface from the bone attachment. Although this seems radical, it is a relatively simple surgery with few complications. But once again, this is reserved for runners that have failed conservative care for a prolonged time. Additionally, if this pain has been chronic, you may want to speak with your doctor about ruling out small stress fractures. Bones constantly are going through a repair process of small, non painful/asymptomatic microfractures, and there are theories that stress fractures occur when these microfractures don't heal and become painful and larger. Speak with your doctor, if he/she hasn't already considered this.