A common problem with some young athletes is the development of “shin splints”. Shin splints are also known as medial tibial stress syndrome (MTSS). This condition can be extremely painful and limit athletic participation. If not treated, the entire sport season may be lost. Shin splints isn’t limited to the young athlete, but can affect the older walker and jogger. It is caused by an inflammation where the shin muscles attach to the tibia or the large bone below the knee that ends at the foot. Shin splints encompass 10-15% of running injuries. This article discusses the onset, diagnosis and treatment of shin splints.
What Causes Shin Splints?
The symptoms occur primarily at the front and inside of the tibia. There are many causes of shin splints to consider. These include:
- Sudden change with aggressive training activity or routines
- Running long distances or on bleachers or hills
- Dancing
- Volleyball, tennis and other running sports
- Biomechanical problems with the feet and ankles (flat feet, pronation and supination)
- Running on hard surfaces (road, basketball court)
- Military training type activities or long hikes up and down hills with a backpack
- Overtraining and not allowing the tissue to recover
- Poorly fitting shoes
Development of anterior compartment syndrome is a concern. The acute syndrome is a medical emergency. Chronic compartment syndrome can be treated conservatively. Another possibility with anterior shin pain is stress fracture of the tibia or fibula.
Symptoms of Shin Splints
Symptoms may begin as a dull ache or a sharp pain in the front of the lower leg. Most of the time pain and discomfort can be felt on the inside of the lower leg, but it can also be felt on the outside. Some common symptoms are:
- Pain present when touching the inside of the lower leg
- Sense of weakness in the lower leg
- Numbness
- Increased shin pain when bending foot and toes
- Pain with activity or pain developing a day or two following activity
- Lumps and swelling felt at the attachment of the muscle to bone
When you see your doctor be prepared to discuss when the symptoms began, a description of the pain and the quality of the pain. Describe the location and what aggravates the symptoms. Communication with your health care provider will assist in the diagnosis of shin splints and the treatment recommendations for the condition.
Treatment
The goal of treatment is to reduce pain and swelling and return to normal activity. Patient involvement can expedite recovery. Understanding what is expected during treatment encourages compliance. What can you do to relieve the pain? Some treatment suggestions are:
- Rest – Time is needed for the muscles to heal. This may involve 2-4 weeks of avoiding the activity that precipitated the shin splints.
- Compression Support – Helps to reduce the swelling during the acute phase.
- Cryotherapy or Ice – Reduces the swelling and inflammation to allow healing to begin.
- Properly Fitting Shoes – Maintains and supports the foot and ankle.
- Exercises – Exercises are given as soon as the acute presentation has diminished.
- Heat Recommendations – Moist heat applied to the anterior shin helps with healing after the acute stage has subsided.
- Maintain Activity – Cross train with activities such as biking or swimming.
Treatment in the clinic may include:
- Application of Treatment – Modalities such as muscle stimulation, ultrasound, Kinesotape and manipulation of the foot and ankle to improve biomechanical function.
- Soft tissue massage – Myofascial trigger point treatment to the injured muscle and active muscle release to help restore function.
- Advice on Returning to Sport or Activity – Guidance to minimize a return of symptoms.
- Foot Orthotics – Obtaining the proper orthotic for your workout or running shoes helps in the support of the foot, arches and ankle.
- Appropriate Exercise Prescription – Utilizing exercises too early in the care and treatment may serve as a constant aggravation and prevent recovery. Knowing when to begin exercising and monitoring compliance are helpful in the recovery process.
- Surgery – This is rarely needed with shin splints.
If anterior shin pain persists in spite of 2-3 weeks of self-care or if the pain does not let up and is worsening, consult a health care professional immediately.The doctors at Coon Rapids Chiropractic Office have experience in treating shin splints.