Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Shin Splints is a painful condition of the shin. The person having this condition would experience pain along the front i.e. inner or medial part of his leg. Typically the pain is concentrated in the lower leg between the knee and ankle joints, on the line of shin bone. In some cases, swelling may also be seen along the inner parts of the lower leg. This condition is also called by another name ‘Medial Tibial Stress Syndrome’ / MTSS.
In this article we shall try to understand Shin Splints from an Ayurveda perspective and list out the possible Ayurveda interventions for this condition.
Related Reading – ‘Shin Splints’
Shin Splints – A Vata predominant condition
Since the condition ‘Shin Splints’ is marked by pain and or swelling in the inner part of the lower leg it appears to be a predominantly vata condition. It is caused by aggravation of vata and hence may be caused or triggered by the nidanas – etiological factors meant and mentioned as causing aggravation of vata. The lower portion of the body, including the lower limbs is the territory of dominance of Vata. The interventions too demand a ‘vata controlling protocol’.
From the perspective of causative factors
Looking at the causes of Shin Splits too, it is clear that all the factors favor vata aggravation. Moderate to heavy activities undoubtedly would pinch Vata and tempt it to go on a rise, especially when not complemented by good rest.
Strenuous physical activities would lead to wear and tear in the body, subsequently leading to tissue destruction i.e. dhatu kshaya. Dhatu Kshaya of any range is an ideal ground for abnormal vata increase.
This should be compensated by rest and good rest to support the tissues undergoing destruction, along with medicines and therapies which would relieve vata and hence the pain and swelling of shin caused by vata aggravation.
Severe pain and symptoms would indicate severity of vata aggravation and aggressive therapies and medicines would be needed to combat vata and the symptoms it is causing. A combination of both external and internal therapies like an effective herbal oil massage with mild sudation combined with Vasti – herbal enemas which are the best remedies for combating Vata will be required along with required lifestyle and dietetic corrections in case of presence of severe pain due to excessive aggravation of vata.
Asthigata Vata and other conditions which can be considered to understand Shin Splints through Ayurveda lens
These etiological factors leading to the chain of events causing Shin Splints can be considered as Asthigata Vata, the aggravated vata getting stubbornly localized in the bones leading to further wear and tear and destruction of bone. Long standing stress over the bones and excessive force on the bones would eventually upset vata. We need to remember that the bones are important seats of vata. In fact Shin Split looks like a combined condition of Asthigata Vata and Mamsagata Vata (aggravated vata getting stubbornly localized in muscles).
The stress on the shin bone can also be due to overweight and excessive fat in the body, a condition which can be considered as Medo Avruta Vata – excess fat clogging the pathways of vata and meddling with its normal functioning, in the bones in this context. Fat blocking the channels of the body, those carrying the nutrients to the bones in this context (Medasavruta Marga), will lead to improper and immature formation of bones due to insufficient nutrients being supplied to the bones, which due to the pressure imparted by surrounding tissues will be susceptible to cracks, tears and wears. This is also responsible for stress fractures.
From the perspective of risk factors
Now, look at the risk factors from an Ayurveda perspective. Running of any kind i.e. downhill or hard, slanted or uneven surfaces – will all lead to vata aggravation. Weakness of muscles of thigh or butts, lack of flexibility and foot abnormalities also aggravate vata in the long run. Similar is the impact on vata in those indulged in improper training techniques and military activities and in athletics and dancing.
All these can cause mild to moderate trauma in the bones leading to their breakage, wear and tear. All these are due to external factors and can be considered as Agantuja Nidanas. Abhighata – injury, damage or trauma is one of the most important causative factors of vata aggravation.
From the perspective of symptoms of Shin Splints
Symptoms of Shin Splints and Dosha relationship
| Symptoms of Shin Splints | Dosha relationship |
| Dull ache in front of the leg / inner part of lower leg | Vata |
| Pain on either side of shin bone | Vata |
| Tenderness / soreness along the inner part of lower leg | Vata |
| Swelling in lower part of the leg | Vata |
| Muscle pain | Vata |
| Pain that develops during exercise | Vata |
| Numbness in the feet | Vata |
| Weakness in the feet | Vata |
Once again, through the analysis of symptoms of Shin Splints through Ayurveda lens, we learn that it is completely a ‘vata predominant pathological condition’.
Ayurveda treatment for Shin Splints
Nidana Parivarjana
One should avoid all the causative factors for vata aggravation, mainly strenuous physical activities.
Treatment principles
Shin Splints should be treated on the lines of –
– Vata vyadhi
– Asthigata vata
– Mamsagata vata
– Majjagata vata
– Asthi kshaya
– Asthivaha sroto dushti / Asthi pradoshaja vikara
– Bhagna chikitsa
External Treatments
– Abhyanga with herbal oils which alleviate Vata – like Ksheerabala Taila, Balashwagandha Lakshadi Taila, Mahanarayana Taila etc.
– Swedana – sudation – for relief from pain and swelling
– Udwarthana – for mobilizing excess accumulation of fat
– Taila Dhara – the same oils used for providing Abhyanga should be used to conduct dhara – showering of oil on the affected leg
– Dashamula Ksheera Dhara – Milk boiled with Dashamula should be used for showering over the affected bone, and will provide instant relief from pain and swelling / inflammation.
– Lepa and Upanaha – anointment of pastes and application of poultices prepared with vata alleviating herbs.
Internal Treatments
– Virechana – therapeutic purgation for relieving pain, inflammation and swelling
– Vasti – medicated decoction and oil / ghee enemas – best therapies for combating severe aggravation of vata. Guggulutiktaka Ghrtam is the best one for unctuous enema. A combination of oil and ghee will make for a useful anti-vata enema while Mahasneha – a combination of all fats – oil, ghee, bone marrow and muscle fat is the best for combating bone, bone marrow and joint related disorders.
– Snehapana – Daily metered doses of sneha – unctuous materials like Guggulutiktaka Ghrta should be administered orally, mixed with ghee.
Beneficial formulations
– Panchatikta Ghrta Guggulu
– Yogaraja Guggulu
– Mahayogaraja Guggulu
– Trayodashanga Guggulu
– Lakshadi Guggulu
– Maharasnadi Kashayam
– Varanadi Kashayam
– Guggulutiktakam Kashayam
– Guggulutiktakam Ghrtam
– Gandha Tailam