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Shin Splints

Shin Splints is a general term used to refer to the pain along the shinbone or the tibia. The pain is known to occur as a result of an overload on the shinbone and the connective tissues that attach the muscles to the bone. The shinbone or tibia is the large bone in the front of the lower leg (Fig 1).

In laymen terms, it is an injury to the front of the outer leg. It usually occur after period of relative inactivity. The condition is very common amongst runners and other athletes.

Incidence

Shin splints are one of the most common medical conditions in the category of “overuse injuries” and occur mostly in runners or aggressive walkers.

Beginning runners are also at an increased risk, as they are not used to the high impact, which running has on the muscles and joints of the lower leg and foot.

Medial Tibial Stress Syndrome (MTSS)

Experts suggest that the term ‘shin splints’ has been widely used as a catch-all term referring to a collection of different conditions that cause leg pain.

However, the term medial tibial stress syndrome (MTSS) is known to better define the injury and separate it from injuries such as stress fractures or compartment syndrome. MTSS is reportedly caused by chronic strain, overuse and microtrauma of the calf muscle at its origin on the shinbone.

Characteristics of Pain

The pain associated to MTSS is characteristically located on the outer edge of the mid region of the leg, next to the shinbone.

In addition, an area of discomfort measuring 4-6 inches (10-15 cm) in length is often present. The pain associated to shin splints has a certain set of typical characteristics. Here we list the most common ones:

• Pain increases with activity
• Pain located on the medial or inside part of the lower leg
• Pain that often aggravates with running or other weight bearing exercises
• Pain, which increases after running on hard surfaces
• An aching pain, lingering long after stopping activity
• Pain increasing after running, jumping, hill climbing or downhill running
• Tightness or inflexibility in the calf muscles

Causes

Shin splints are known to be the result of an inflammation from injury to the tendon (posterior peroneal tendon) and adjacent tissues in front of the outer leg.

The most important cause of the pain of shin splints is trauma to either the muscles or bones of the lower leg. Muscle trauma is often related to overtraining or excessive running on hard surfaces.

Factors that mainly contribute towards occurrence of shin splints include muscles, training errors, footwear and foot structure.

Some of the most common causes of shin splints include:

• Improper stretching
• Lack of warm-up
• Overtraining
• Rapid increase in mileage
• Excessive pronation
• Tight posterior muscles
• Jumping or running on hard surfaces
• Muscle imbalance between the posterior and anterior leg
• Worn out footwear
• Running on a slanted or a tilted surface
• Biomechanical issues

Treatment and Self Care

Depending upon the intensity of pain, the following treatment options and self-care measures should be observed:

• Rest: Refrain from all activities that cause pain. For instance, running, impact cardio class and jumping
• Ice: Apply ice 2-3 times a day. The best way is to crush ice in a plastic bag and keep it over the shin for 15 minutes. You can also massage the area with an ice cube for five minutes
• Medication: For relief from pain and inflammation, medication including aspirin or ibuprofen can be taken
• Footwear: Wear proper footwear and replace as required. Experts suggest replacement of shoes at every 400 miles. You can try shoes that have a firm arch support and a well-padded heel
• Tape: Taping the shins can also help in reducing stress

Exercises

For relief from the pain and discomfort of shin splints, it is extremely important to follow an exercise regimen of stretching (for reducing tension along the shin) and strengthening exercises (for the leg muscles to prevent re-injury).

Stretching Exercises

1) Calf Stretch

• Stand with your feet pointed forward

• Keep your heels down and back leg straight.

• Slowly bend the front leg until you feel a gentle upper calf stretch in the back leg.

2) Heel Stretch

• Stand with your feet pointed forward and heels down.

• Slowly bend the back leg until you feel a gentle lower calf or heel stretch along that leg.

For Shin Splint Advice from the Stretching Institute - Click Here

Strengthening Exercises

1) Outer Shin

Sit on a chair and push your foot outward (sideways)against an object.

2) Inner Shin

Sit on a chair and push your feet inwards against each other.

Bucket handle exercises, toe-raises and outward rolls are some other important strengthening exercises to prevent re-injury.

Once the treatment is over, return to your normal sports activity and notice for any reversal signs of the pain. You should also continue with the stretch and strengthening exercises of leg and ankle muscles.

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