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Ankle sprains and shin splints are often viewed as “minor” sports injuries. You roll your ankle, ice it, and carry on. You get shin pain, rest for a week, and run again. However, for many people, these injuries become a recurring plague. The ankle gives way again and again. The shin splints return every time you increase your mileage.
At Breakthrough Pain & Performance, we understand that these are not just tissue injuries; they are Neurological Failures. An ankle sprain damages the brain’s map of the foot. Shin splints are a sign that the body’s shock-absorbing reflexes have failed. We treat the software (the brain) to fix the hardware (the leg).
When you sprain your ankle (inversion injury), you stretch and tear the ligaments on the outside of the foot (ATFL). These ligaments are not just ropes; they are sensory organs packed with mechanoreceptors.
When the ligament tears, the connection to the brain is severed. The brain loses its “GPS signal” from the ankle. It no longer knows exactly where the foot is in space.
This leads to Functional Instability. Your ligaments might heal and tighten up, but your ankle still feels wobbly. You roll it again on a flat pavement. Why? Because the brain’s reaction time is too slow. It cannot fire the peroneal muscles fast enough to catch you when you start to roll.
We treat the ankle as a sensory deficit. We use Proprioceptive Retraining. We use balance boards, vibration, and eyes-closed drills to force the brain to re-map the ankle. We sharpen the reflexes so the muscles fire in milliseconds, providing dynamic stability that a ligament alone cannot provide.
Medial Tibial Stress Syndrome (Shin Splints) is pain along the inner shin bone. It is often blamed on “impact.” However, it is actually a failure of Vibration Dampening.
When your foot hits the ground, a shockwave vibrates up the tibia bone. Your muscles (Soleus and Tibialis Posterior) are supposed to contract to dampen this vibration, like holding a ringing bell to stop the sound.
If these muscles are fatigued or neurologically inhibited, they fail to dampen the shock. The bone vibrates excessively. This vibration causes the periosteum (skin of the bone) to pull away, causing inflammation and pain. Eventually, it causes micro-cracks in the bone (stress reaction).
We assess why the dampening muscles aren’t working. Often, it is due to Deep Posterior Compartment Syndrome. The fascia around the muscles is too tight, choking the muscle and preventing it from functioning. We use soft tissue release and neuro-lymphatic drainage to open the compartment. We then retrain the timing of the muscles to ensure they dampen the shock effectively.
Shin splints can affect both flat-footed and high-arched runners, but for different reasons.
We don’t just prescribe orthotics. We train the foot. For the flat foot, we train the Intrinsic Muscles to build an arch. For the rigid foot, we mobilise the joints to create flexibility. We treat the foot you have, optimizing its mechanics to protect the shin.
After an ankle sprain, many patients have lingering pain on the outside of the foot that feels like a pebble in their shoe. This is often Cuboid Syndrome.
The Cuboid bone gets subluxed (stuck out of position) during the sprain. It locks the foot, preventing normal movement. It also inhibits the Peroneal muscles, making the ankle unstable.
We can fix this instantly. We use a specific manipulation (the “Cuboid Whip”) to restore the bone’s position. The relief is often immediate. The “pebble” feeling goes, and the strength returns to the ankle.
Some active people in Shiremoor suffer from pain that builds up during a run and feels like the legs are going to explode. This is Chronic Exertional Compartment Syndrome. The muscles swell with blood during exercise, but the fascia is too tight to expand. The pressure rises, cutting off blood flow and causing ischaemic pain.
While severe cases need surgery (fasciotomy), many can be managed by altering Running Mechanics. If you are a “heel striker,” you use the anterior shin muscles heavily. If we switch you to a mid-foot strike or increase your cadence (steps per minute), we reduce the pressure in the compartment significantly. We use video analysis to retrain your gait and offload the painful zones.
1. The Sensory Reset: We re-map the ankle in the brain using sensory drills.
2. The Mechanics: We unlock the stiff joints (talus/cuboid) and support the mobile ones.
3. The Loading: We build tissue tolerance in the calf and shin muscles.
4. The Return: We guide you through a return-to-run program that manages bone stress and vibration.
This clinic is for you if:
We build ankles and legs that can handle the ground.
