What Are Shin Splints?

Shin splits are typical categorized as an overuse leg injury. This is because they are usually seen in runners and athletes who increase their running or activity. It is a pain on the lower part of the leg located next to the shinbone (tibia). It is caused by stress on the shinbone and tissue that attaches the muscle to the bone. Another name for shin splints is medial tibial stress syndrome. Shin splints are very common in both new and experienced runners. They can be caused by many different factors but luckily most people experience a full recovery after the proper shin splint treatment plan.

Causes

The pathophysiology of shin splints is irritation of the periosteum (the outer layer of the cortical bone) and swollen muscles due to excess running or walking. Most common causes iinclude: overpronation which causes the arch in the foot to collapse and puts extra stress on the legs; poor shock absorption which increases tibial shock (stress to the bone and the muscles decelerating the body progression. Another common reason is excessive vertical oscillation during running.Typically runners who increase their mileage are at the most risks for shin splints. They can also be caused by running downhill, on uneven or hard surfaces, or from wearing old worn out shoes or simply wrong shoe for their foot type. Another source of shin splints is poor biomechanics. Whatever the reason there is many effective forms of rehab that can help heal shin splints and prevent them in the future.

Symptoms

The first sign of a shin splint is pain below the knee on the front outer part of the leg. The pain usually starts while doing an activity such as running. The amount of pain can range. Sometimes runners can continue through the pain and other times the pain is so extreme they need to stop. The symptoms also include tenderness and soreness on the inner part of the leg, moderate swelling, and sometimes the feet begin to feel numb because the swollen muscles begin to irritate the nerves. These symptoms can occur in both new and experienced runners.

Differential Diagnosis

Shin splints can have similiar symptoms as stress fracture of anterior compartment syndrome.Clinical evaluation and radiologic evaluation may be necessary in severe cases.

Diagnosis

The diagnosis of a shin splint starts with a physical exam and thorough look at the patient’s history. If the doctor suspects stress fractures a MRI or X-ray will be prescribed. Typically the pain is in the front outer edge of the leg, right around the tibia bone. Sometimes there is also swelling around that area. These signs are all used to help diagnose shin splints. Also used to diagnose the cause of the shin splint is gait and running analysis. These tests are important for finding causative biomechanical faults and preventing shin splints in the future.

Treatment of Shin Splints

If you start to experience signs of shin splints the first step is to rest and take a few days off from activity. Also icing the shin for 10 minutes after activity can help keep the swelling down and reduce pain. You can still be active but only with low impact activities such as swimming or biking. Replacing old running shoes could help solve the problem in mild cases. With mild cases taking anti-inflammatory medications along with icing and rest can heal the shin splints but in order to prevent them from coming back proper strengthening and stretching need to be done. In more severe cases that involve stress fractures of the tibia a more involved treatment needs to done. When biomechanics are the cause then the type of treatment needs to be very specific to the patient and their biomechanical faults. Computerized gait and running analysis may be necessary.
Also extracorporeal shockvawe therapy has proven to be an excelent choice for this condition. High frequency sound waves such as shock waves have regenerative effect to chronicly overused soft tissue especially at soft tissue bone interface. It acts by bringing new blood vessels to the area of chronic blood supply deficit.

Results from Treatment

The severity of the injury will determine the recovery rate and progress. Typically people have full recoveries from shin splints, if the right treatment plan is followed and preventive measures are taken.

Prevent Future Shin Splints

There are a few simple things you can do to prevent shin splints. The simplest thing to do is get a proper pair of running shoes which match your foot type. Cross-training with low impact sports such as swimming can also reduce the chances of shin splints. Adding strength training and eccentric stretching to your regular workout routine can prevent them as well. There are specific exercises which runners should perform on regular basis in order to keep muscle balance in the foot and the leg. Most importantly the Increase in milage should be do e gradually so that tissue loading rates are not exceeded.