He sought me out because of his severe shin splints on the right low leg, lateral to the tibia, which haven’t resolved over a period of 1,5 years despite various visits to specialists, gait analyses and physiotherapy sessions. He also complaint of occasional low back pain, piriformis syndrome and a deep pain in his groin. I was immediately suspecting psoas and iliacus including the QLs on the back to be major players in this. On palpation he had a clearly distinct line of connective tissue tightened from the base of the scapula around latissimus dorsi, the abdominals, especially the insertion points at the ribs and the oblique muscles. Further along psoas major, minor and iliacus, hence the groin pain. Gluteus medius was well developed but showed very old adhesions that connected into tensia fascia late and down the IT band to the tubercle of Gerdy. From there the line continued somewhat around tibialis posterior and into the Achilles heel to the bottom of his metatarsals.
I also noticed a lot of connective tissue restrictions around the lower ribs, probably affecting the intercostal muscles. I felt the urge to ask him about an accident, probably some time ago. He told me that he broke some ribs 10 years ago while he was working in some remote area of the world, hence he never got it checked and doesn’t know exactly which rib(s). I suspected an issue with his shoulder joint as well, as the latissimus dorsi is pulling on the scapula. He suffers from general tightness in his shoulder area from time to time and especially on the right side. I wanted to figure out if there was an emotional component to the whole situation, but even after subtle suggestions and directed questions, he didn’t want to tell me anything. The only thing he said was that he needs to run to get rid of his worries and organise his thoughts. That’s why the shin splints I guess, so he needs to sit down and actually sort it out – confront it in some way. First I thought, the tension in the hips indicate “not moving forward” and then I connected the ribs and got the impression that the incident of the rib fracture was around a time of inner turmoil which affected him more than he would give away. Whatever it was, it was his to deal with.
For 2 sessions twice per week over a period of 3 weeks I worked very deeply on these connective tissue connections to break them up and lengthen the tissue and stretch the muscle. I advised on regular stretching and very little running since his shin splints were just under control again as he was seeing another physiotherapist who applied a lot of dry needling and helped him with strengthening exercises for his gluteus mucles and adductors.
He had to leave town for one month and only did yoga for stretching, especially side bending, hamstrings and quadriceps and a bit of running during this time. When I saw him today his body felt more balanced and the connective tissue on the right side of his body didn’t feel as ropy or “harsh” under my fingers. This was a very positive finding and as he also reported that his shin splints are not near as bad as they were before the treatment and resolve much better with a few days rest. I believe that in his case it was important to work with the body and keep the conversation focused around exercise, strategies and what can be done in the future. He was a smart and rational person who understand a lot about his body and enjoyed working with it. Maybe through yoga he can find a way to better listen and feel what his body has to tell him so he can use the message to finally resolve his shin splints for good.