Greetings Hephzibah, sorry to hear you are having shin/ankle pain. I am a chiropractor and have helped many people with the type pain you describe (however, never over the internet). In fact, I just worked on a AT hiker’s anterior shin this past Sunday, somewhere between Tri-Corners shelter and Davenport Gap shelter, at the North end of the Smokies.
Please understand that I am going by your description only, and it is very hard to diagnoses over the internet. However, your description was great, so I will try to help.
I would much rather show you this techinque in person, but I will try to describe it to you the best I can. You are correct that it is muscular. This muscle is called the Anterior Tibialis. Very few muscles are surrounded by bone, but this muscle is. Thehuge bone (Tibia) that runs down the front of your shin and the long little bone (Fibula) which runs down the outside of your leg, from Knee to Ankle, almost totally encircle this muscle. So, with overuse (that can really happen on the AT), it tends to grow/swell/hypertrophy. With this growth, the muscle has no where to go, being surrounded by bone, therefore PAIN. This happens regularly in high school sports during the first few weeks of practices.
This muscle, the Anterior tibialis, pulls your foot into dorsiflexion, as you noted. When you do this motion, you can see the muscle raise up on the front of your leg. That was a little background on the Anterior Tibialis, here is the therapy!
Remember, #1. Ice #2. Dig #3. Stretch
First, you should ice the front of your shin. Laying an ice pack across it will work(5 minutes), but ice massage is much better. Here is how to do Ice Massage: Grab a chunk of ice in a rag, and repeatedly drag an exposed edge of that chunk of ice from your ankle all the way UP your shin, stopping 2 or 3" below the knee. Make sure you keep the ice right on top of the Anterior Tibialis muscle. Press down with quite a bit of force. Remember, just pull the ice UP the shin, starting just above the ankle joint, going UP to just below the knee. DO NOT rub DOWN the shin. Ok, ok, I know ice is not a commodity on the AT, so if you have to you can skip this part. However, a 2 1/2" ice cold river rock could be used for this part. Grab a nice egg size rock out of one of those cold creeks, and have at it.
Second, DIG. You need to run your fingers up the belly of the muscle. You should really be digging into the whole length of the Anterior Tibialis muscle. You should find several VERY Tender spots (size of a quarter, down to the size of a pea). You now must DIG into these spots, using a circular motion. Just use the end of your finger, backed up by a finger from the other hand to apply enough pressure. You cannot damage this muscle by digging into it with your fingers. Apply as much force, maintaining this circular digging motion, as you can stand. Repeat this to all tender spots for about 45 sec. to 1 minute each. You will probably find at least 3 very tender spots, up to the whole muscle feeling very tender and painful. This digging should be done at least once per/day. More often will not cause a problem, and could help you recover faster, but once or twice is plenty. NOTE: Be careful to say on the muscle with this deep digging motion, and not on the actual shin bone.
Third, STRETCH the Anterior Tibialis: You already know the action of this muclce, it dorsiflexes the foot. To stretch this muscle, you need to plantarflex and slightly internally rotate the foot. Do this by sitting and crossing the affected ankle over the other knee. Now, reach with your hand and grab hold of the whole end of your foot. Bend your toes, along with your foot, into plantarflexion. It helps go grab the back of your affected leg, around the achilles tendon, with your other hand, and push away from you. (Plantarflexion is bending the toes down, toward the bottom of your foot, toward the arch of your foot.) HOld this stretch for 20 to 25 seconds, and repeat 3 or 4 repetitions. This stretching should be done a number of times each day. If you are hiking in trail shoes, you may be able to do this stretch while taking breaks. With boots on, it is hard to get a good stretch.
Lastly, I do this strech while standing as part of my daily exercise warm-up. I’ll let you figure out how to do it standing, but it involves sticking your foot behind you, toe and laces of shoe on the ground. Then you push down with your body, while doing a partial lunge with the other leg. Like I said, I wish I was there to do a “show and tell”, it is much easier that way.
Hope this was helpful and easy enough to understand. Feel free to ask questions about any part of this you did not understand. Happy trails to you, may your legs feel fresh and new by morning, the Lord give you the wind at your back and the view to your front!!! Dr. Keith aka --chirokid–
chirokid
