Tuesday, May 9, 2017

Creating a Better Joint

Abstract: For this project, I chose to find a way to fix “shin splints.” For this project, I first researched the bones and muscles that make up the lower leg or what we call our shins. I focused on one specific type of shin splints - the medial tibial stress syndrome. What I found is that medial tibial stress syndrome occurs when the muscles of the lower leg are strained and pull on the periosteum. This may cause inflammation and irritation, so I began to think of ways to reduce stress on the lower leg. I hypothesized that if the areas surrounding the periosteum of the shin bone were more heavily supported by muscles, it would make it harder to strain the shin. Thus, I decided to design my better shin with more muscles and tendons surrounding the tibia bone as I believe these additions would make the shin harder to strain.

Main Body: Medial tibial stress syndrome (commonly known as “shin splints”) is a very common cause of shin pain in runners, tennis players, and even dancers, and is primarily the result of the overuse or repetitive strain of the sheath surrounding the bone, which then causes inflammation and pain. In medial tibial stress syndrome, when the muscles of the lower leg are strained, they start to pull on the periosteum (the sheath that surrounds the the shin bone), which rapidly causes pain and inflammation. This injury normally results when a person suddenly overuses the shin muscles by running too far too fast, training on hard surfaces, failing to stretch before running, wearing worn out shoes and running on your toes. There are also a number of factors that can increase the likelihood of getting medial tibial stress syndrome: overpronation, oversupination, inadequate footwear and training too quickly.
Medial tibial stress syndrome - shown in the image above on the left - mainly affects the shinbone (tibia) and the calf muscles that surround the tibia, like the tibialis anterior, soleus and gastrocnemius. The tibialis anterior muscle (the muscle I focused on) is a very long and slender muscle located on the anterior side of the leg below the knee. It originates from the proximal edge of the tibia and it runs vertically down the front of the leg, parallel and lateral to the tibia.

One design feature that may reduce the frequency of the medial tibial stress syndrome is adding more muscles around the shin bone (the tibia). The addition of muscles would bolster the shin and reduce the inflammation and pain that occurs when the shin is overused. Because there is more muscle padding, the muscles will be less likely to tear or wear out when overused and will be more resistant to strain from workouts. In addition, more tendons to connect the newly added muscles to the tibia bone would support both, the bone and muscles of the shin. Because tendons are strong collections of fibrous collagenous tissue, they will make movements like pronation and supination (which can cause shin splints) much easier to do, while the added muscles will prevent overpronation and oversupination from causing damage to the shins.

In addition, these newly added muscles and tendons would need support from the three main arteries of the lower leg: peroneal (fibular) artery, anterior medial malleolar artery, posterior tibial artery, and anterior tibial artery. The posterior tibial artery and anterior tibial artery both run down the course of the lower leg and distribute nutrients to the superficial and deep muscles surrounding the tibia. These three arteries would need to be slightly longer so that they can provide nutrients to the additional muscles.
As a track and field sprinter, I’m especially familiar with shin splints. I’ve had shin splints many times, especially when the season starts and we rapidly begin full-speed training or when I immediately start sprint workouts after not having run for a couple days. Sprinters most commonly get shin splints from to overtraining because the muscles in the shin and/or the tibia bone are damaged. The “easy fix” that athletic trainers give to sprinters that show early symptoms of medial tibial stress syndrome is to wrap their ankles and shins with athletic wrap in order to hold the muscles in place. The point of this is to try to stabilize the muscles for the short term. In the long run, though, sprinters are advised to warm up their muscles before running and to strengthen their muscles. Adding more muscles and tendons around the tibia would accomplish all of these goals and act as a sort of “permanent tape” to reduce the chances of a person getting shin splints. The tendons would stabilize the muscles and hold them in place and the additional muscles would support the tibia, all of which would make the shins stronger and more resistant to sudden exercise.

One potential setback from this modification to the shin is that adding more muscles could limit the range of motion for the shin. In much the same way that wrapping ankles and shins limits the ankle joint from dorsiflexion, plantar flexion, inversion, and eversion, these modifications may limit movement as they will make the lower leg much more bulky. However, when the lower leg is pronated and supinated, these modifications will definitely support the shin and prevent injury.

Discussion: I arrived at the idea for this design when I began reading more in depth about the functions of muscles and tendons and how they work together to create movement in and around joints. While researching, I realized that what I needed to prevent the shin from medial tibial stress disorder was to reduce the stress on the tibia. Thus, I concluded that adding more muscle and tendons around the shin bone (tibia) would act as a cushion and make the shin more stable and secure from injury. This assignment definitely furthered my understanding of the functions of muscles and tendons, how they work together to enable movement, and how they work together to prevent injury.

Because we cannot actually redesign our joints, we must rethink how we treat our bodies instead. Because this injury normally results from overuse of the shin muscles, we must ease into workouts, train on softer surfaces, remember to stretch before running, wear shoes that are intact and try not to run on our toes. All of these will decrease the likelihood of getting medial tibial stress syndrome by controlling pronation and supination and preventing injuries that are caused from poor or worn out footwear and training too quickly.

Works Cited:
"Arteries of the Lower Limb." TeachMeAnatomy. N.p., 15 Feb. 2017. Web. 09 May 2017.
"Shin Pain (Shin Splints)." Summit Medical Group. McKesson Corporation, 2014. Web. 09 May 2017.
"Shin Splints and Stress Fractures." Chiro Up. ChiroUp, 10 Mar. 2017. Web. 09 May 2017.

Tortora, Gerard J. Introduction to the Human Body. New York: Wiley, 2006. Print.

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