The Ankle Series: Floppy Ankles, Sore Shins? Maybe it is Time for a Rethink!

Floppy ankles… I see them on an almost daily basis, calves so tight that as soon as my clients lay down on the treatment table their ankles flop forward as if preparing to dance for  ‘The Royal Ballet’.  For many reasons it appears that our calves have shortened up.  Be it the high heels we wear, the amount we train or simply the time we spend on our feet, what is certain is that tight calves prevail.

So what have these floppy ankles got to do with sore and tender shins?  Shin splints, for any of you have suffered from this painful condition, are caused by the muscles and tendons that attach to the shin bone (the Tibia) pulling on the bone and causing ache and sometimes acute pain.   Its generally not the bone that is hurting but the tendons themselves from being overly tight and strained. This muscle that attaches to the front of the shin is the Tibialis Anterior which dorsi-flexes the ankle (pulls your toes towards your head) and also inverts the ankle.  Treatment can focus on releasing the tension in this muscle, massage, stretching and the like to relieve the pressure and pulling on the shin bone.  But have you been doing this yet not seeing any results?

Well look again – are you or your client of the ‘Floppy Ankle’ variety? If so then consider this:  if the muscles at the back of the leg are constantly pulling your ankle into plantar flexion (pointing of the toes) then the opposing muscles, in this case the Tibialis Anterior is being constantly pulled and strained.  Logic would therefore have it that in order to give relief to the shin you actually need to be releasing and stretching the muscles at the back of the lower leg.    Believe me it is a lot easier to stretch the calves then the Tibialis Anterior!


Now the hard part – why are you calves getting tight in the first place?  This can be for many reasons and why it is worth seeing a therapist for a full assessment.  Firstly, are you simply training too hard?  A lack of rest days and training too much too soon can lead to the muscles tightening up.  Get a training plan.  It doesn’t have to be complex but it is important that you build yourself up gradually to meet your training goals.  As a general guideline try to increase your training frequency, intensity or duration by no more than 10% a week to ensure you stay injury free.  Warm up and cool downs are also important.
Next up is gait and running technique.  Are you a forefoot runner or a heel striker? Do you pronate or supinate?  How you walk and run has a massive impact on your body.  Not only that but what you walk or run in makes a real difference.  Are your shoes right for you?  Are they worn out?
Moving up the chain away from the feet your hips can play a significant part in the biomechanics of your ankle.  A large proportion of the population have an anteriorly tilted pelvis leading to an over strained posterior chain pulling your ankles into plantar flexion.  No amount of treating your Tibialis Anterior will solve this problem.  And the list of possibilities go on…..
I certainly don’t mean to panic you, but I simply want to highlight that if you are suffering from shin splints, have tried various treatment but are not reducing the pain then it is time to look beyond the obvious.   Don’t give up, just get assessed by your local therapist and treat the root cause of your problem.
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