Shin Splints From Double Bass?

It is time for another Q+A, and this question also comes from Instagram. @harryharelund asks:

Is it possible to get periostitis/shin splints from drumming?When playing double bass, for example?

Yes. It is totally possible. Common even. However, it is also avoidable and, as far as I can tell, a sign that maybe you should re-evaluate your technique. Here’s the deal:

Periostitis is a condition where the periosteum gets inflamed. In medical jargon, -itis means inflammation of.  The periosteum is the top layer of bone and it connects the bone to the connective tissue (see the image at the right). Recent research is finding that it isn’t a separate layer that connects the two together so much as the bone morphs into connective tissue. There are no clear boundaries. So, it might be better to just think of the periosteum as where connective tissue turns into bone and force generated by the elastic, stretchy muscles get translated into the rigid, compressible bone structure.

Inflammation of this area is generally caused by infection or overuse. If it is an infection, then you are likely to have chronic problems and severe pain. If that is you, see a doctor about it. However, this is likely unrelated to drumming, unless you are doing something deeply wrong.

Overuse is what is common in drumming. There isn’t a clear consensus, but the general idea is that shin splints are little tears in the muscle/periosteum/bone and/or inflammation of the periosteum.

Pain in the shin doesn’t necessarily mean shin splints. There are a lot of things that could cause pain, including a stress fracture. Quick rule of thumb is that if the pain is localized, then it probably isn’t shin splints and you’re likely to want to see a doctor is the pain doesn’t go away. Stress fractures are not common in drumming, however. They’re mostly likely caused by your non-musical life. However, like shin splints, you may notice them while drumming even if they are caused by other activities.

Drumming shouldn’t cause shin splints. Shin splints themselves are caused when the muscles in the front of the shin, such as the tibialis anterior (see image at left), work so hard that they cause excessive damage. These muscles are responsible for lifting the front of the foot while pressing the heel down – a movement called dorsiflexion. As this movement is necessarily away from the bass drum pedal, it isn’t really that useful in drumming. Check out my feature in DRUM! Magazine in February 2016 or, of course, my book Anatomy of Drumming for more information. If you find yourself needing to lift your foot out of the way with that type of movement then you are likely working much harder than necessary – and sacrificing speed and power along the way. I’ll post another blog detailing the reasons why soon.

Doctors generally agree that if you get shin splints then you should take it easy for a while and perhaps take steps to reduce the inflammation. This means ice and, if the pain is severe, pain relievers. Just be aware that pain relievers can cause hearing damage. Read more about ototoxicity here. 

Personally, I’m of the belief that if inflammation is part of the body’s natural response, then you shouldn’t take too many steps to reduce it unless the inflammation itself becomes a problem. This is much debated issue, and there are  highly educated, extremely smart, extremely experienced people on both sides.