When you first start running as a way to loose weight or drop stress, shin splints, unfortunately can occur. Treat it early and stay stretched to reduce the pain. Personally, I find the trigger points in my shin are hard to really release unless I use something small – like a small massage ball (some are smaller than a tennis ball) or, even better, the TheraCane since it’s nubs seem to be that perfect size. Others like the Muscle Release Balls, which are comparable to the size of a tennis ball, but are smooth (not fuzzy) and have different densities for you to choose from.
If you are runner, or have any kind of shin or top of foot pain (which could be connected to this trigger point, too), read on…
Massage Therapy for Shin Splints
Perfect Spot No. 3, in the tibialis anterior muscle of the shin
by Paul Ingraham, Vancouver, Canada
Trigger points (TrPs), or muscle knots, are a common cause of stubborn and strange aches and pains, and yet they are under-diagnosed. The 13 Perfect Spots are trigger points that are common and yet fairly easy to massage yourself — the most satisfying and useful places to apply pressure to muscle. For tough cases, see the advanced treatment guide.
- Pain Location: in the shin, top of the foot, and the big toe
- Problems: shin splints, drop foot, anterior compartment syndrome, medial tibial stress syndrome
- Related Muscles: tibialis anterior
If you have shin splints — which is a painful, potentially serious condition — you may prefer to visit this detailed tutorial: Save Yourself from Shin Splints! This article summarizes the basics of self-massage for your shin musculature. Note that rapidly developing severe shin pain can be a medical emergency. If this is your situation, you are in the wrong place: don’t read this article, go to a hospital emergency room. I am not kidding.
Perfect Spot No. 3 is in your shins — seemingly an unlikely place for muscle knots! But there is meat there, and if you’ve ever had shin splints then you know just how vulnerable that meat can be. Even if you’ve never suffered so painfully, your shins probably still suffer in silence — latent trigger points in the upper third of the shin that don’t cause symptoms, but are plenty sensitive if you press on them. They inevitably form here because you walk on two legs, and usually on hard surfaces.
Relieving tension in Spot No. 3 may also be helpful for plantar fasciitis, because the shin musculature is surprisingly important for arch support. Along with the tibialis posterior muscle … and less so the arch muscles than you might think.1
We usually think of the shin as a bony place, but in fact there is a good-sized muscle on the lateral face of the shin: the tibialis anterior muscle. The tibialis muscle works almost alone: it is the only muscle that strongly lifts the foot. Functionally, its major job is not to shorten, but to lengthen in a controlled way: to gently lower the forefoot after the heel strikes the ground. This requires an eccentric contraction — the muscle contracts while lengthening, as your biceps does when you lower a barbell.
Without the tibialis anterior’s powerful and well-coordinated eccentric contractions, your foot would slap ungracefully onto the ground with every step. On hard surfaces like concrete, the strain of preventing foot slapping is immense. For runners, that strain is often how shin splints usually begin, and is one of the main reasons to avoid hard-surface running. Eccentric contractions are known to cause additional muscle soreness after exercise, which is why the shin muscle tends to get really sore after running hard — and why the muscle tends to develop large, chronic trigger points.
Another situation where the tibialis anterior has to work especially hard and tends to get really sore is coming down a mountain: because of the downward slope, the foot must be lowered further with each step, which means more eccentric contraction.
Without the tibialis anterior, your foot would slap ungracefully onto the ground with every step.
If you feel the inside surface of your shin, you will find hard bone, covered only by skin. On the outside surface of the shin, however, there is a thick pad of muscle starting about two inches below the knee: that’s the tibialis anterior. The Perfect Spot here is actually a whole patch of common trigger points in the top third of the muscle (see attached diagram). They are not hard to find, and they are usually very potent.
Pressure on any of tibialis anterior’s key trigger points will likely cause an almost paralyzing “good pain” that radiates down the shin into the top of the foot and toes. You will probably be surprised by the amount of sensation flooding down the leg: the tibialis anterior is a Perfect Spot because it almost always produces so much more sensation than anyone expects. It’s one of those spots that makes my clients say things like, “Wow, did you know that was there?” Amaze your friends!
The tibialis anterior is a really tough muscle. Unless you actually have shin splints (see below), these spots will usually tolerate plenty of pressure. To treat someone else, you may find that your thumbs alone are not quite strong enough; using an elbow or the blade of your forearm will make things much easier. Start gently but work steadily up to a satisfying pressure, and hold it until the intensity of the sensation gradually fades.
You can also use some massage oil or lotion to slide the blade of your forearm or the heel of your hand up the length of the tibialis anterior. This is quite a satisfying variation, combining the pleasure of good old-fashioned Swedish massage with the unique sensation of a trigger point at the top of the stroke.
To treat yourself, lean your shin into something hard, like the edge of a park bench or a tennis ball: whatever’s handy. I had an old hot-water radiator once that was perfect!
What about shin splints?
If you have shin splints, or you are helping someone with shin splints, you should handle this Perfect Spot cautiously. It can be helpful, but you must also be careful not to make the condition worse.
There are different kinds of shin splints, such as tibial stress fractures and medial tibial stress syndrome, neither of which can be helped much by massaging the tibialis anterior.
But another common kind of shin splints, anterior compartment syndrome, may respond well to the right kind of massage. This condition is caused by swelling of the compartment (think “sausage wrapping”) that the tibialis anterior muscles lives in. If this problem develops quickly, it can be dangerous — it can actually destroy the muscle, and lead to potentially life-threatening infection. If you have severe, rapidly developing shin pain, please go to the emergency room!
Slower cases are not dangerous: they just cause chronic pain. And trigger point therapy may calm the tibialis anterior muscle down enough to help relieve the problem. The trick is to give the tibialis anterior some help without increasing the pressure in the muscle compartment any more than it already is. Traditional Swedish massage strokes are completely out of the question in this situation: strongly stroking up or down the length of the muscle with broad pressure will just increase the pressure, like rolling up a toothpaste tube without undoing the cap. The trick is to just use point pressure on the Perfect Spot itself: locate it and apply only moderate focussed pressure to the trigger point, and this may help the muscle without irritating the whole muscle.
This is just the briefest of introductions to shin pain. For (much) more information, see Save Yourself from Shin Splints!