posterior shin splints: improving blood flow?

I have had chronic tibialis posterior tendonitis in both legs for four months, and have been out of training for six weeks now. However, my condition has not improved at all in the last four weeks. It feels like it’s about 50% healed, and the healing proccess seems to be arrested at this point. Physical therapy has been mostly unhelpful and I have stopped going.

I want to try to improve blood flow to the area passively (without stressing the injured tendon with exercises). I have tried showering the affected area with hot water, but the heat doesn’t seem to penetrate deep enough. Thus, my thoughts at this point are ULTRASOUND and EMS. These are the only aspect of physical therapy that did seem helpful, but the limitations on durations and frequency of these treatments prevented me from recieving much benefit as I was only able to schedule appointments once or twice per week week.

So, I am willing to purchase either an ultrasound unit or an EMS unit, or both if it can be done for under $200 (which I doubt).

This is where the knowledge and expertise of the congregation here come in. My questions are:

  1. Which modality would be superior for expediating the healing of my damaged tibialis posterior tendons? Note that I am not interested in using EMS for strengthening purposes- I just want to improve blood flow to the injury site.

  2. What specifications in machines of both types (particularly EMS) should I look for, given a spending cap of $200? Again, just for the purpose of improving blood flow, not for performance enhancement.

  3. Where can I get these machines without a prescription? (PM me or email me at if forum rules prohibit you from posting this information).

  4. I found a cheap, generic 1-3 MHz ultrasound unit on ebay for $150:


Would this be useful? There are more like it available if I don’t snatch this one within the 12 hours left on the auction.

PLEASE HELP!!! My legs are desperate.

Thanks in advance…

donatello, save your money and answer some questions. Age, sport involved in, height, weight, number of years in involved sport, previous injuries from feet to low back, foot and ankle mechanics (be a objective as you can), training leading up to injured state, x-rays, mri, cat? Why do you think its TP tendonitits? What treatment have you recieved in therapy?


Thomas, I don’t really want to talk about all of those things. I want to talk about EMS and ultrasound. However, I will say that it is obvious that I have tibialis posterior tendonitis. I can palpate the tendon and feel that it is injured. PT was such a joke that it’s not even worth discussing.

EMS and Ultrasound only are ineffective!
A good therapy work (soft tissue) with EMS and/or ultrasound can help you.
Restore your muscle length, blood flow, limphatic dreinage and break the inflammatory cycle and your muscle heal!

OK. I don’t think I can help you further.

As a PT, your statement is ridiculous. You have contradicted yourself a couple of times. i.e. the PT was a joke, it was not helping/the EMS and US were working so I want to buy a unit.

You also mention that your results were not that great, but neither was your compliance “I could only go once or twice a week.” And you refuse to answer questions of someone who was willing to help you alleviate your pain and functional limitations and possibly save you $200 or more.

If you would like information on finding good therapists or have other questions, I will be glad to help you. As for the questions you have asked previously, do a google search and you should be able to find all the information you need.

CLIMBON there is nothing contradictory about my statements. I said that PT was “mostly” useless, with the exception of the EMS and ultrasound treatments. The rehabilitation aspect was useless at best (and injurious in at least one instance). It was a generic cookie cutter regimen, probably designed around older non-athletic clients who get shin splints just from waddling around at 300 lbs. I have been to four different PT clinics in my area over the course of my athletic career and most of them operate this way- so I’m done with it. Fuck PT.

As for my compliance, the scheduling was at the therapists’ discretion, and he dictated that I should come in twice per week. I’m not an elite athlete and I don’t have access to a therapist for soft tissue work every day. Of course, they gave me exercises to do at home, but they were utterly worthless.

The problem is that the tendon is not HEALING. Doing stupid little foot exercises is not going to make the tissue heal any faster. In fact, exercises just seem to irritiate it and inhibit healing. That’s why I’m seeking to facilitate healing with passive modalities for a few weeks.

With all due respect to you and Thomas, whose efforts I appreciate, producing the information he requested is not going to allow anyone to help me any more effectively. The tendon is injured, it has to heal before I do anything else. The end.

Earlier this week I consulted the podiatrist who referred me to the therapist, and he suggested that the tendon may be healing slowly becuase I don’t get much blood flow to that area. Thus, I deduce that increasing blood flow via ultrasound and EMS may be helpful. If you disagree, then I would certainly consider your opinion. Otherwise, however, I’d just like to know what kind of machines to look for.

I work in a rehab clinic with a bunch of PT’s and can understand your frustration - sometimes there is a quantity of patients vs. quality of treatment issue. However, that being said, answering the above questions will be you better responses and RESULTS, than simply bitching and asking about how to use EMS/US. There are a lot of people on the board who have been through the same issues, or work rehabbing these issues and would be able to give you some great advice. Otherwise, see below:

Why are you saying EMS and Ultrasound alone (per se) are ineffective? My experience here is that anything causing an improved flush and blood flow - as well as an effort to smoothly improve one’s general fitness and aerobic condition - could actually significantly improve the situation,particularly when correct therapy (and knowledgeable,competent,and reliable therapist) is not readily available.

Simply because they are not addressing the cause of the problem. Sure they might temporarily increase circulation in the area thus making the healing process faster, BUT if nothing else is done, as soon as he starts training again the tissues will become inflamed again - so what’s the point? Pain is not the problem, the cause of the pain is.

Donatello, your best bet is to answer Thomas’ questions and not waste your money in machinery.

You are incorrect. Healing is the first thing that has to occur.

The best thing for healing of any tendon is movement. What do you think is going to bring more blood flow, active movement or a machine? The correct answer is active movement. The key is to perform enough movement to aid healing and not too much that would inhibit healing. If you would answer some of the previous questions and the following, I am sure that we all would be able to offer you better advice on how to handle your specific situation. As it stands right now, all you are asking for is a “cookie cutter” response.

What activities increase your pain? relieve some or all of it? ROM? strength? How did you injure it? previous history of injuries? What kind of treatment (specifics, please) have you received or performed on your own?

I don’t know about ultrasound devices, but if I were to buy an EMS machine, I would choose one with EMS and TENS options. I would also choose one where you can control the settings manually. I prefer keeping EMS/TENS as supplementary rehabilitation modalities since, that’s what they are; they can enhance a working rehab protocol.

Do you have any idea of what has aggravated the injury? Are you flatfooted? Do you pronate? Are you sure there’s not a tear of any kind?

Donny, your dogmatic approach to treatment and rehabilitation, I feel, will lead you into a frustrated state. Which it appears has already happened, which in turn may create more pain and disability.

There is a great deal of FREE knowledge on this site from PTs. ATs, physios, etc…take advantage of it.

Thomas, no offense, but you’re an idiot and you shouldn’t be giving advice to people on the internet.

Climbon, I suspect that you’re at least as incompetent as my therapist. You should forfeit your license.