Shin Splints describes a
variety of generalized pain that occurs in the front
of the lower leg along the tibia (shin bone). Shin
Splints are considered a cumulative stress injury because
they often occur after repeated stress or jarring of the
bones, muscles and joints without proper conditioning or
recovery between workouts. The pain of shin splints is
typically located on the outer front portion of the lower
leg (anterior shin splints) or pain on the back inside of
the lower leg (posterior medial shin splints.
Causes
The pain of shin splints is caused by trauma to either the
muscles or bones of the lower leg.
Muscle trauma (exertional
compartment syndrome) is often related to
overtraining or excessive running on hard surfaces.
Repeated use makes the
muscles swell and puts pressure on the fascia that covers
the muscles in the lower leg leading to pressure and pain.
Bone trauma to the lower
leg can result in
stress fractures. Constant pounding the leg bones may
cause microscopic cracks and fractures in the tibia and
fibula (lower leg bones). Rest is needed to repair these
cracks, but without adequate recover, these cracks continue
to grow and become a fracture. The result is acute pain and
a long recovery.
Beginning runners are at
increased risk of shin splints and stress fractures because
they are not used to the high impact running has on the
muscles and joints of the lower leg and foot. Running on
hard surfaces (especially with worn, poorly cushioned
footwear) increases stress on the muscles, joints and bones
and is another cause of shin splints. Excessive
pronation or other biomechanical problems can increase
the risk of developing shin splints. Other causes of shin
splints include:
- Improper stretching
- Lack of
warm-up
- Training too hard
-
Increasing mileage too quickly
- Running or jumping on
hard surfaces
- Muscle imbalance between
the posterior and anterior leg
-
Worn out shoes
that do not have enough support
- Running on a tilted or
slanted surface
- Other biomechanical
issues
Symptoms
- Pain located on the
medial (inside) part of the lower leg
- Pain is often worse with
running or other weight bearing exercise
- Pain increases after
running on hard surfaces
- An aching pain may
linger after stopping activity
- Pain increases with
activity
- Pain increases with
running, jumping, hill climbing, or downhill running
- Calf muscles may be
tight and inflexible
Treating Shin
Splints
Rest is the best treatment for shin splints. For immediate
relief use the
R.I.C.E. treatment method for controlling pain and
inflammation. Returning to activity must be done gradually
with non-weight bearing activity (cycling, swimming) to your
workouts until pain-free.
- Strengthening and
stretching exercises are helpful. The
ankle injury rehab program can also be used for shin
splint rehab.
-
Tape your shins
to reduce stress
-
Weat proper footwear
-
Replace shoes as
needed.
Returning to activity must
be done gradually or you risk re-injury. Change your routine
and cut your exercise time and intensity so that you have no
discomfort before, during or after exercise.
If your shin pain continues
after three or more weeks, you should consider seeing you
physician for a proper diagnosis.
A shin splint is pain resulting from damage to the muscles
along the shin.
The usual cause is
long-standing, repeated stress to the lower leg. Two groups
of muscles in the shin are
susceptible to shin
splints. The location of the
pain depends on which group is affected.
Anterolateral shin splints affect
the muscles in the front (anterior) and outside (lateral)
parts of the shin. This type
of injury results from a natural imbalance in the size of
opposing muscles. The shin
muscles pull the foot up, and the larger and much stronger
calf muscles pull the foot down each time the heel touches
the ground during walking or running. The calf muscles exert
so much force that they can injure the
shin muscles.
The main
symptom of anterolateral shin
splints is pain along the
front and outside of the shin.
At first, the pain is felt only immediately after the heel
strikes the ground during running, walking, skiing, or other
similar exercises. If the person continues to run, the pain
occurs throughout each step, eventually becoming constant.
Usually by the time the person sees a doctor, the
shin hurts when touched.
To allow
this type of shin splint to
heal, the runner must stop running temporarily and do other
kinds of exercise. Exercises to stretch the calf muscles are
helpful. Once the shin
muscles start to heal, exercises to strengthen them, such as
the bucket-handle exercise, can be done in 3 sets of 10
every other day.
Posteromedial shin splints affect
the muscles in the back (posterior) and inner (medial) parts
of the shin, which are
responsible for lifting the heel just before the toes push
off. This type of shin splint
often results from running on banked tracks or crowned roads
and can be worsened by rolling onto the outside of the feet
(pronation) excessively or by wearing running shoes that do
not adequately prevent such rolling.
The pain
produced by this type of shin
splint usually starts along the inside of the lower leg,
about 1 to 8 inches above the ankle, and worsens when a
runner rises up on the toes or rolls the ankle in. If the
person continues to run, the pain moves forward, affecting
the inner aspect of the ankle, and may extend up the
shin to within 2 to 4 inches
of the knee. The severity of the pain increases as the
shin splint progresses. At
first, only the muscle tendons are inflamed and painful, but
if the person keeps running, the muscles themselves can be
affected. Eventually, tension on the inflamed tendon can
actually pull it from its attachment to bone, causing
bleeding and further inflammation.
The primary
treatment is to stop running and do other types of exercise
until running is no longer painful. Running shoes with a
rigid heel counter (the back part of the shoe) and special
arch supports can keep the foot from rolling onto the
outside excessively. Avoiding running on banked surfaces can
help prevent shin
splints from recurring.
Exercises to strengthen the injured muscles are useful.
An
experimental treatment consists of
calcitonin(a hormone that builds bone) injected daily or
alendronate(a drug that slows bone loss) given by mouth;
this treatment has healed some shin
splints that were
unresponsive to other measures. Sometimes none of the
available treatments are effective, and the runner must
abandon running permanently.
Strengthening the Shin
Muscles
