shin splints

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Shin Splints

 

Definition

Shin splints refer to the sharp pains that occur down the front of the lower leg. They are a common complaint, particularly among runners and other athletes.

Description

Shin splints may refer to a number of lower leg complaints and injuries. In most cases, shin splints refer to the pain that results from overload on the tissues that connect muscles to the shin bone (tibia). They also may come from the small bone of the lower leg and ankle, called the fibula. The medical term for shin splints is medial tibial stress syndrome.
Next to ankle sprains, shin splints are probably the most common complaint of injury to the lower body. Most shin splints occur in the front (anterior) portion of the tibia; some also occur in the inside of the leg along the tibia. Runners probably suffer shin splints more than other people, but they also occur in people who play basketball and tennis and those who walk long distances, particularly on treadmills.

Causes and symptoms

The most common cause of shin splints is overdoing activities that constantly pound on the legs and feet. This may include sports with many stops and starts, running down hills or other tilted surfaces, or repeated walking. Simply training too long or too hard, especially without proper stretching and warm-up, can cause shin splints. People with flat feet, high arches, or feet that turn outward may be more prone to shin splints. Shoes that are worn or don't provide proper foot support also add to the problem.

Diagnosis

The physician will check the leg for tenderness. If the pain is in a single area of the tibia and hurts to the touch, the cause may by a stress fracture. The physician may order an x ray to rule out a stress fracture, but shin splints often can be diagnosed without x rays.

Treatment

Physicians usually recommend a period of rest for people with shin splints to let the area heal. Usually, about three to four weeks is recommended, though the time varies depending on the patient and injury severity. Shin splints may be treated in phases, beginning with absolute rest and gradual return to activity. Ice and elevation of the foot may be used to help relieve pain and swelling in the first phase. If the person needs to keep in shape, stretching and water exercises that keep the foot from bearing weight may be allowed after initial treatment. As the patient returns to normal function, orthotic footwear and braces may be added to prevent re-injury.

Alternative treatment

Various massage techniques may help speed up recovery. Homeopathic physicians may recommend Rhus tox. Those using alternative remedies should ensure they are certified practitioners and should coordinate care with allopathic providers.

Prognosis

With proper rest, management, and prevention, people with shin splints can return to normal activity in a few weeks or more. However, continuing to perform the activity that caused the shin splints can lead to stress fractures of the tibia.

Prevention

Re-injury is most common in the first month after return to normal activity, and patients who have had shin splints should return to previous activities cautiously. The following can help prevent shin splints from occurring in people who run and perform stop and start physical activities:
  • Warming up and stretching calf muscles before running or jogging. A podiatrist specializing in sports medicine or other sports medicine specialist may recommend specific stretching exercises.
  • Strengthening muscles in the front lower leg (anterior tibialis) with resistance exercises or by walking on the heels three times daily for about 30 yards.
  • Wearing quality shoes with arch supports. Runners should purchase new shoes about every 400 miles. A podiatrist can design special arch supports or orthotics for people with flat feet.
  • Runs should be started at a slow pace and gradually increased.
  • Athletes can cross-train in a sport that does not impact the feet and lower legs as much, such as swimming or riding a bicycle.

Resources

Periodicals

Metzi, Jordan D., Joshua A. Metzi. " Shin Pain in an Adolescent Soccer Player: A Case-based Look at 'Shin Splints': Do you Care for Children Who Regularly Run or Play Sports? Then You Should Have a Basic Understanding of the Different Entities that Can Cause Shin Pain. That List Includes Tibial Stress Injuries and Exertional Compartment Syndrome." Contemporary Pediatrics (Sept. 2004):36-39.
"Shunning Shin Splints." Muscle & Fitness (Aug. 2003):38.
Smith, Ian. "World of Hurt." Men's Health (June 2003):40.

Organizations

American Academy of Podiatric Sports Medicine. P.O. Box 723, Rockville, MD 20853. 888-854-3338. http://www.aapsm.org.

Other

Shin Splints.Foot.com Web site, 2005. http://www.foot.com/info/cond_cond_shin_splints.jsp.

Key terms

Podiatrist — A physician who specializes in the medical care and treatment of the human foot.
Stress fracture — A hairline fracture (narrow crack along the surface of a bone) that is caused by repeated stress to the bone, such as from jogging, rather than from a single heavy blow.

shin splints

also

shinsplints

(shĭn′splĭnts′)
pl.n. (used with a sing. or pl. verb)
A painful condition of the shins caused by inflammation of muscles and connective tissue, frequently occurring among runners.

shin splints

A popular term for pain in the lower leg muscles and bones occurring in runners and football players and made worse by exertion. Causes include COMPARTMENT SYNDROME, muscle tear, MYOSITIS, PERIOSTITIS or tendon inflammation.
References in periodicals archive ?
Filled with the wisdom and research findings of more than 25 experts, this book brings you foundational information about MTSS plus concrete guidance on creating a system to help all learners reach their potential.
General education faculty had expertise in areas of English learner instruction and literacy instruction; special education faculty had expertise in positive behavior supports, assessment, MTSS, and instruction of students with mild/moderate disabilities.
Beginning in 2009, mTSS referrals declined annually, whereas nmTSS cases remained stable.
[11,12] In this study patients with MTSS also responded well to a treatment programme, which included gait retraining.
Because one purpose of the present study was to examine how time spent on ASCA-aligned activities influences school counselors' MTSS knowledge and skills, the language of the SCPIS ratings was adapted with the authors' permission to measure the frequency with which school counselors participate in ASCA-aligned activities.
Of 181 army recruits who were included in this study with a mean age of 30.7 [+ or -] 4.68 years, 30 participants (16.6%) were in MTSS group (age: 29.52 [+ or -] 3.88 years, height: 173.76 [+ or -] 6.57 cm, and weight: 80.20 [+ or -] 11.63 kg) and the other 151 participants (83.4%) were in control group (age: 30.26 [+ or -] 4.83 years, height: 174.40 [+ or -] 7.84 cm, and weight: 83.10 [+ or -] 17.48 kg).
It is very important for the clinician to differentiate MTSS, which is a rather benign condition, from different types of stress fractures in this region and acute compartment syndrome (ACS) that are much more serious conditions [8].
Alli se describe el MTSS usando solo tres rasgos: primeros molares inferiores de tres raices (3-rooted LM1), incisivos centrales superiores con forma de pala (shoveling UI1) y segundos molares inferiores de cuatro cuspides (4-cusped LM2).
The study included patients who were diagnosed with MTSS, because they showed the typical symptoms of pain following exercise as well as tenderness of the anterior or posterior medial and lateral anterior surfaces of the tibia [2, 23].
Patients who completed 10 years of treatment and also had X-rays available at baseline and year 10 demonstrated an average change of 2.8 in modified total Sharp score (mTSS), a measure of radiographic inhibition.
A The usual diagnosis is of a medial tibial stress syndrome (MTSS) which typically produces pain on the inner, distal shin bone in a linear fashion.