Shin Splints

Don't let them stop you

Shin splints are painful and stop many runners in their tracks.  But here is some information to get you back on track

Shin splints , also known as medial tibial stress syndrome are a collective term for leg pain usually located along the front part or medial (inner) part of the leg. The shin (medically known as tibia) is the large bone in the leg which can be felt in front of it. Shin splints are the result of an overuse injury that leads to inflammation of the muscles, tendons and bone. It’s also an exercise induced leg pain. It accounts to about 60% of overuse injuries of the leg. Shin splints typically occur in runners (the most known running injury) as well as people who join in jumping sports and activities such as tennis, basketball, squash, gymnastics and dance.

 

More common in females, shin splints are experienced by about 10-20% of runners at least one stint in their career. Shin splints can be an anterior shin splint or a posterior shin splint.

 

Different pathological conditions can cause shin splints. These are:

·        Stress fracture of the tibia

·        Periosteitis

·        Irritation of the interosseous membrane

·        Musculotendinitis

·        Overpronation (rolls inward) of the feet

·        Oversupination (rolls outward)of the feet

·        Tight calf muscles and hamstrings

·        Excessive stress placed on one leg

·        There’s sudden increase in the frequency or intensity of training

·        Poor knee alignment

·        Running on hard surfaces or slopes

·        Faulty biomechanics when jogging or running

·        Decreased flexibility at the ankle joint (Achilles tendon)

·        Inadequate stretching

·        Weak thighs and buttocks

 

People who are overweight, running with inappropriate or worn out shoes, flat feet or have very rigid foot arches are also at risk of developing shin splints. With repetitive stress and pounding on the lower leg musculature, the body won’t be able to repair and heal itself. And when the body doesn’t have time to rest, the pounding can result to cracks that will further lead to a stress fracture or complete fracture.

 

Symptoms

The most common and main symptom of shin splints is pain on the area of the shin. A dull aching pain is felt on the lower two thirds of the inner part of the leg. Pain develops during or after exercise or activity. The area may also be sore and tender or painful to touch as well as swelling. Lastly, there might be presence of weakness and numbness on the foot.

 

Diagnosis

When symptoms are getting worse, consider to visit your doctor. Normally, shin splints are diagnosed based from the patient’s medical history, symptoms and physical examination. And since shin splints can be due to pathologic conditions, imaging tests like X-ray of the leg are added by the physician to rule out other problems or to determine the probable cause of shin splints.

 

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Treatment

The goals of shin splint treatment are to reduce pain and inflammation, correction of biomechanical problems, strengthening and restoring muscles to its original state.

 

During the acute stage where the area is still inflamed, the symptoms must be treated with rest and appropriate pain modalities. Any activity that had lead to shin splints should be ceased to prevent the symptoms to get worse. Application of ice to the inflamed area is helpful. If there’s swelling, compress and elevate the leg to reduce swelling. Anti-inflammatory drugs are also prescribed to reduce pain. Low impact activities like stationary biking, swimming and elliptical machines may be done during this stage of recovery.

When the patient is already in the sub-acute to chronic stage, therapeutic exercises such as stretching and strengthening are included to the management. Stretching the calf muscles and Achilles tendon is necessary to increase the flexibility of the lower leg as well as the ankle. In addition, stretching of the tibialis anterior (muscle in front of the leg) can also be helpful for a more mobile leg. Strengthening of the lower leg musculature, ankle and foot is performed to stabilize the leg. Most importantly, patient is educated to proper body mechanics and correction of faulty postures during activity.

 For patients with anatomical problems of the foot, an orthosis and supportive shoes are helpful.

So what can you do?

Try cross training

 Try a running specific cross training tool like the Bionic Runner.  It not only will give you the high cardio workout you crave, but it will exercise a similar set of muscles.  A stand out feature of the Bionic Runner is that it has a pivoting pedal, which will help protect you from shin splint pain.  Get back to training now.