Shin Splint

Shin Splint – Exercise Induced Pain in the front Area of Lower Legs

Shin splint is a term which is used to define the exercise induced pain in the front area of the lower legs or the shins. The pain is felt during or after an energetic activity especially at the time of sports or running with sudden stops and starts in the case of tennis and basketball. The shin pain occurs with a feeling of dull ache and if it is ignored and the person tends to continue with the exercise, it could be very painful and one would have to discontinue exercising.

The person suffering from pain should avoid running through the pain since the shin pain could be an injury to the bone as well as the surround tissues in the leg. With continuous strain on the leg, it could make the pain and the injury worse. The person should stop the exercise altogether which could cause the pain for at least a couple of weeks. They should choose the activities which do not put much strain on the shin like cycling, cross training, swimming or yoga. There are various causes of shin splints and the risk includes:

• If one has been running for less than five years
• If one has been running on hard surfaces or slopes
• Wearing poorly fitting or worn out trainers which does not protect and support the feet adequately
• Are overweight since this puts extra stress on the legs
• Have flat feet or the feet roll inwards, since this puts more pressure on the lower legs
• Have weak ankles or tight Achilles tendon, the band of tissues which connect the heel bone to the calf muscle
• Have tight calf muscles

Medical Tibial Stress Syndrome - MTSS

Medical Tibial Stress Syndrome – MTSS is the most common cause of shin splints and is the result of regular and intense periods of exercise when the body is not accustomed to it. Long distance running and sports with stopping and starting increases the risk of MTSS. Sudden increasing of the distance and or the pace one tends to run are also some of the common causes.

These exercises or activities tend to place plenty of stress on the legs and could cause injury to the bone together with the surrounding tissues. It is considered to occur when the layer of connective tissue that covers the surface of the shin bone or periosteum tends to get inflamed. It can get inflamed when excessive pressure is placed on the shin or if the foot rolls excessively when it hits the ground. This is considered to be an over-pronation putting abnormal force through the tibia and the shin bone and the pain is experienced in both shin which could take several day or maybe weeks for the pain to subside once the activity is stopped.

Treatment to Ease Pain 

Activities need to be stopped causing the pain for a few weeks after which the pain tends to lessen and one could slowly restart the activity once again. Shin splints tend to often heal without much treatment though it is advisable to get an X-ray or bone scan in case of any fracture. The following is recommended to ease the pain and recovery:

• Give the body rest since it needs time to heal
• Ice the shin to ease pain and swelling. It can be done for 20 -30 minutes every 3 to 4 hours for a period of 2 to 3 days or till the pain disappears
• Take anti-inflammatory painkillers which will help to ease the pain and swelling under doctor’s advice
• Use orthotics for shoes. Shoe inserts that can be custom made or bought could help with arches which may collapse or flatten while standing up
• Do range of motion exercises as instructed by the physician
• Use a neoprene sleeve in order to support and warm the leg
• Go for physical therapy in order to identify and treat problems with the legs or running mechanics which could be causing the shin splints. A therapist could be helpful to ease the pain

In some rare cases, the person may also need surgery if they tend to have a severe stress fracture causing the shin splints. Shin splints tend to fully recover when:

• The injured leg is as flexible as the other leg
• The injured leg feels strong as usual
• You can sprint, jog and jump without experiencing any pain
• X-rays are normal and show stress fracture is healed

Precautions After Recovery 

The person could return back to their usual activity after a couple of weeks only after the pain has disappeared. Activity level should be done gradually building up the time spend running or indulging in sports. Running on flat, soft surface like a recreation ground or playground can be done after recovery.

 Keeping the distance and the intensity of the run to 50% of what was prior to the injury. If the pain tends to return, stop the activity immediately. After a period of three to six weeks, gradually increase the distance of running and after six weeks one can gradually begin increasing the pace. The individual should ensure that proper warm up before starting the exercise and thereafter take time to cool down.