Dear Readers,

Welcome to our latest edition of The Overhead Athlete’s Edge! Today, we’re diving into a common but often overlooked issue affecting baseball players: shin splints. Whether you’re on the mound, in the outfield, or sprinting to first base, understanding and managing shin splints is crucial for maintaining peak performance and avoiding prolonged downtime.

In Focus: Targeted Training to Prevent Shin Splints

Shin splints, or medial tibial stress syndrome, refer to pain along the inner edge of the shinbone (tibia) resulting from inflammation of the muscles, tendons, and bone tissue around the tibia.

Why do shin splints happen?

• Resuming training after taking time off - muscles and surrounding tissues are not conditioned to handle the sudden increase in activity

• The use of spikes and cleats - cleats can increase the impact on the lower leg muscles when running and quickly changing direction and speed. During push off when running, the spikes stick to the ground, making your calf, achilles, plantar fascia, and foot muscles work harder to generate speed

• Playing on hard or uneven surfaces (such as dirt or artificial turf) - these surfaces offer less cushioning and ability for your foot to adapt, and increase the stress and strain on your foot and leg muscles

• Overuse and overload - the load of training and competition becomes more than your body can accommodate. Here we see a lot of movement compensations, poor stress responses, and injury

What Can I Do to Prevent Shin Splints?

1. Incorporate field training and conditioning in spikes during the off-season so the body can recognize and adapt to the specific demands of running and playing in cleats once the season starts. This one recommendation is so important and something we incorporate into our return to play programs at The Training Room.

2. Ensure proper footwear on and off the field. This is different for each person, so if you aren’t sure what is best, ask your sports physical therapist or athletic trainer

3. Gradually increase activity at the start of a training regimen or season. Build a foundation of strength, especially in your feet and hips, and progressively ramp up your plyometric activity.

4. Dynamic warm up and mobility routine before training sessions and games. Mobility at the ankle, the big toe, and hip are especially important for preventing (and recovering from) shin splints.

5. Strength Training - Get those glutes strong! Increase the power you get from your hips to take the load off of your feet and legs. Include foot and ankle strengthening into your training regimen.

6. Adequate Rest and Recovery - Check out our last newsletter for some tips!

7. Surface Awareness - Sometimes this is unavoidable in a game situation, but be smart and mindful of your training environments.

8. Cross Training - Allow your body to be familiar and strong moving in a variety of ways to avoid overuse and prevent injury.

Expert Insights: You think you have shin splints. What should you do?

Your may be told to rest and to stop the activity that is causing you pain. But maybe it’s playoffs or a high stakes tryout, and you can’t afford to ride the bench. Can you play through shin splints? Well, yes, you can depending on your pain tolerance. But will your performance be affected? Yes, it is likely you won’t be able to perform at your peak levels. So what should you do?

Make sure to monitor and address symptoms early. Consult with your sports performance physical therapist or athletic trainer. Manual therapy and other recovery techniques can be really beneficial in keeping symptoms at bay, helping tissue healing, and ensuring you can stay on the field during game day. Be diligent with your home exercise and training program. Be sure to include these recommendations into your rehab program:

• 1st ray (big toe mobility) - you need a certain amount of extension here for proper walking and running mechanics

• Ankle dorsiflexion mobility - restrictions here lead to a lot of strain on the shin and compensations up the chain

• Strengthening through your toes, arch of your foot, and ankle into all directions, in different positions, on different surfaces, and both barefoot and in footwear

• Strengthening of the lower leg muscles gradually increasing weight and strain, performing exercises without an increase in pain; perform isometric, concentric and eccentric exercises

• Mobility and strengthening through the hip, especially working on gluteal strength and power; train your gluteals to work as rotators, and increase their ability to both absorb and produce force while running and cutting.

• Single leg balance and stability - running is a single leg balance activity, so make sure you can do activities on one leg with good control before you advance your training

• Gradual ramp up of plyometrics, monitoring symptoms with cutting, sprinting, jumping, sliding, etc.

Technique Spotlight: Posterior Tibialis (or Tibialis Posterior) Muscle Strengthening

The posterior tibialis muscle is integral to the biomechanics of the lower limb, influencing both the structural integrity of the foot and the efficiency of movement. It supports the medial (inside part) arch of the foot, preventing collapse, and assisting in controlling the foot’s movement during walking and running. Dysfunction or weakness of the posterior tibialis can lead to unwanted biomechanical changes in the foot and thus the whole lower limb, which combined with overuse, can contribute to the development of shin splints.

There are a few exercises I like to strengthen the tibialis posterior muscle. Here is one of my favorite go-to exercises. The tibialis posterior works in conjunction with the other calf muscles to elevate the heels.

Ask the Expert: I get shin splints a lot. Should I get orthotics?

For baseball players grappling with persistent shin splints, orthotics can be a valuable tool during the season to alleviate discomfort and keep you performing at your best. When in-season, the goal is to minimize limitations and manage symptoms, and if orthotics provide relief, they can be a practical short-term solution. However, it's important to recognize that orthotics are more of a temporary fix rather than a cure. The root cause of shin splints—such as improper biomechanics or overuse—needs to be addressed through a comprehensive approach including strength training, proper footwear, and adjustments to your training regimen. Once the offseason arrives, I recommend gradually weaning off orthotics and focusing on addressing the underlying issues to prevent recurrence and ensure long-term health and performance.

Success Story: Overcoming Adversity

This week, meet Chris, our former D1 college athlete who now plays in a competitive men’s baseball league on Sundays. He came to The Training Room with a pretty significant calf strain, affecting his ability to play center field, bat, and run the bases. This injury was also stopping him from running and going to the gym, interrupting his weekly routine. With weekly visits for a month, in addition to an in-depth strengthening and daily home rehab program, Chris has been able to continue playing without missing a game, and is well on his way to a full recovery. Good work Chris!

Stay Connected: Join Our Community

Connect with our vibrant online community of fellow overhead athletes, coaches, and sports enthusiasts by giving us a follow on Instagram @TheTrainingRoomOC. Share your experiences, seek advice, and stay updated on the latest developments in sports performance physical therapy for overhead athletes. Together, we can elevate our performance and achieve new heights in our respective sports.

Closing Note:

Thank you for embarking on this journey with us through the world of sports performance physical therapy for overhead athletes. We hope you found this issue of "The Overhead Athlete's Edge" insightful and empowering. Stay tuned for more valuable information and inspiration in our next edition. Until then, keep honing your skills, pushing your limits, and trusting the process!

Best regards,

Dr. Sam