Last week I was called in to consult on a client, female executive in her 40′s, who complained of right sided shin splints. She was starting gradual low intensity-duration-frequency running after a period of inactivity.

She ran what she called an easy 4 miles then the next day did an “easy” hike with hills. She noticed on the hike some mild discomfort in the inside of her right shin which later swelled to a low level associated with discomfort when walking. She later iced & rested it.

When I examined her, there was mild swelling of her inside right calf, between her calf & tibial bone over her posterior tibialis region (the deepest muscle in the lower leg). Since she had good athletic shoes that adequately supported her mild pronation, I started examining her hips.

In brief, I found out that she had a weak right gluteus medius muscle while all else tested normal. The question then was whether it was inhibition versus genuine weakness. In searching for muscles that could inhibit the gluteus medius, I found that her right psoas (a hip flexor & postural muscle) was shutting down her glutes. After treating the psoas for trigger points & tightness, the gluteus medius muscle tested normal in strength thus confirming my suspicions.

Since the gluteus medius muscle is highly responsible for keeping the pelvis level when balancing on one leg, I suggested that her shin splint resulted from the lower leg getting repetitive strain from trying to compensate for an inhibited gluteus medius muscle above. This made total sense to the client & she was satisfied that her home program of self myofascial release & stretching of the right psoas followed by activation exercises for her gluteus medius would calm down her shins & get her running soon again.