Shin Splints

What is it?

• Shin splints is a term for pain felt anywhere along the shinbone, from knee to ankle. The pain is caused by an inflammation of the muscles, tendons and bone tissue around the front of the lower leg (called the tibia or shin bone). They are common in runners and dancers, and the treatment involves rest and changing your exercise routine. There are different types of shin splints.

• Medial tibial stress syndrome: Medial tibial stress syndrome is the most common type of shin splint, and causes pain along the lower two-thirds of the inside edge of the shinbone. Medial tibial stress syndrome is an inflammation of the muscles, tendons, and bone tissue around the shinbone. It is caused by muscle strain where the muscle joins the shinbone. It gets worse when you run and improves within hours of stopping.

• Stress fracture: A stress fracture is painful in one specific place in the shinbone. The pain is worse when you stand up or exercise, and it takes a while to improve afterwards. It is caused by muscle pulling on the shinbone, eventually causing the bone to crack.

• Other conditions such as tendonitis and compartment syndrome can also cause symptoms like shin splints.

Mechanism of Injury

• In general, shin splints develop when the muscle and bone tissue (periosteum) in the leg become overworked by repetitive activity.

• Shin splints often occur after sudden changes in physical activity. These can be changes in frequency, such as increasing the number of days you exercise each week. Changes in duration and intensity, such as running longer distances or on hills, can also cause shin splints.

• Other factors that contribute to shin splints include:

  • • • Having flat feet or abnormally rigid arches

      • Exercising with improper or worn-out footwear

• Runners are at highest risk for developing shin splints. Dancers and military recruits are two other groups frequently diagnosed with the condition.

Common Management Techniques

Conservative Management

• Rest. Because shin splints are typically caused by overuse, standard treatment includes several weeks of rest from the activity that caused the pain. Lower impact types of aerobic activity can be substituted during your recovery, such as swimming, using a stationary bike, or an elliptical trainer.

• NSAIDS - Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen, voltaren, and naproxen reduce pain and swelling.

• Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.

• Compression. Wearing an elastic compression bandage may prevent additional swelling.

• Flexibility exercises. Stretching your lower leg muscles may make your shins feel better.

• Supportive shoes. Wearing shoes with good cushioning during daily activities will help reduce stress in your shins.

• Orthotics. People who have flat feet or recurrent problems with shin splints may benefit from orthotics. Shoe inserts can help align and stabilize your foot and ankle, taking stress off of your lower leg. Orthotics can be custom-made for your foot, or purchased off the shelf.

Prognosis

Shin splints usually resolve with rest and the simple treatments described above. Before returning to exercise, you should be pain-free for at least 2 weeks. Keep in mind that, when you return to exercise, it must be at a lower level of intensity. You should not be exercising as often as you did before, or for the same length of time. Be sure to warm up and stretch thoroughly before you exercise. Increase training slowly. If you start to feel the same pain, stop exercising immediately. Use a cold pack and rest for a day or two. Return to training again at a lower level of intensity. Increase training even more slowly than before.