When the muscles of the lower leg are over worked they will swell within the confines of the leg and this swelling will cause pain. This is known as shin splints.
In the vast majority of cases this swelling will be the result of an abnormal function within the foot. You do not have to be running a marathon in order to experience shin splints. Simple tasks as walking a long distance may set off shin splints.
It could be argued, the greater the defect in your foot function, the less activity it will take to set off shin splints. That is why for some people, simply wearing the wrong types of shoes will set off shin splints, while others will only notice shin splint pain during an extended work out.
There are other conditions that may cause pain in the lower leg, but it is beyond the scope of this article to go into them. Just be aware that not all pain in the lower legs is shin splints.
In general, shin splint pain will begin during a period of activity, again, as simple as walking or perhaps well into a long run. Some people are able to continue trhough their activity, while others are forced to stop the activity because the pain is so bad. Once the offending activity is stopped, the pain will usually subside, unlike other causes of lower leg pain which will usually continue to hurt.
There are two types of shin splint pain. The first is anterior shin splints and as the name implies it is due to pain in the front of the leg. In these cases it is mainly due to a tight achilles tendon. Because of the tightness of the achilles tendon, the tendon is not as effective when the heel hits the ground. The tendon should be helping the foot "slow down" as we go to foot flat, where the foot is completely on the ground.
In order to make up for this the muscles in the front of the leg have to over work to help slow down the foot as we go from heel strike to foot flat. This excessive load on the anterior leg muscles forces them to swell and you have pain.
The other type of shin splint pain is posterior shin splints. This is pain that will occur in the back of the leg. Individuals who suffer from posterior shin splints tend to excessively pronate or flat footed. As noted in other articles on this site, people who exhibit excessive motion in their feet have a tendency to be flat footed. This extra motion that the foot goes through from step to step causes the muscles in the lower leg, primarily the posterior muscles, to over work. Again, over work will cause a muscle to swell and the swelling causes pain.
Like most musculo-skeletal problems there will be vaying degree of pain from individual to individual and of course there are a variety of treatments for shin splints. Treatment should be determined based on the severity of pain, the activity that causes the pain and the overall foot structure of the individual.
For those who have tried other treatment regimens like icing, stretching, taping and a variety of different shoes or sneakers and are still having pain, then an orthotic is the next logical step, assuming of course other potential medical problems have been ruled out.
Once again, in this instance, we are looking for an orthotic to control the motion of the foot, actually limit the excessive motion of the foot. Less motion=less work by the leg muscles=less swelling.
There are generally no modifications needed in an orthotic for shin splints except in anterior shin splints secondary to a tight achilles tendon. In order to create a relative increase in length of the achilles tendon, a heel lift needs to be added the the orthotic. What a heel lift does is try and create a little more laxity in the tight achilles tendon which will allow it to function somewhat more effectively.
In posterior shin splints, with an orthotic, again, the goal is to reduce excessive motion in the foot to reduce the work load of the muscles.
For this reason, it is possible to try a store bought arch support or to consider an off the shelf medical grade orthotic and in resistent cases even a prescription orthotic.
Basically the descision on what type of orthotic to try centers around the degree of pain one is experiencing and the severity of the foot structure.
With a store bought arch support, if you happen to be lucky enough to have a foot structure that can actually feel the support of the arch support and it supports more than cushions, that may be all you need. Because most of these devices are full length, bulky devices you may be limited in your shoe selection. This should not be an issue if your shin splints are athletically related, but if simple walking sets off shin splints, then there will be limitations.
Seeing a foot specialist will allow you the option of choosing between an off the shelf medical grade orthotic or perhaps a prescription orthotic.
Both of these devices are availabler for those who need to wear an orthotic in a shoe other than a sneaker or work boot. These devices are also a better choice for those who have too much motion in their foot structure. Off the shelf medical grade orthotics and certainly prescription orthotics can both be modified to further restrict the excessive motion of a foot with the additon of what is known as "posting". The front and back of the orthotic can be raised by varying degrees in an effort to make up for the deficiency exhibited in the foot. Remember, the purpose of an orthotic is to bring the ground up to the foot, so that the foot does not have to collapse to the ground in order to ambulate.
store bought arch support usually not much help unless you can find an orthotic that will support the arch. Usually will not work with a high arch foot.
medical grade off the shelf orthotic should use a running orthotic. Depending on amount of pain the orthotic may have to be built up for more arch support in those individuals who do not get full relief.
prescription orthotic because the pain is occurring away from the foot, maximum foot control should yield maximum knee pain relief. That featue can only be found in a prescription orthotic.