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.

Please explore more advanced diagnostic option unavailable anywhere else:

Sonoelastography SMI

Sonoelastography

Sonoelastography is used to diagnose and rehabilitate injured tissues:

– More precise that manual palpation
– Gives us quantitative data to evaluate damaged tissues
– Increases ultrasound accuracy by 15-20 degrees of certainty
– Lets us visualize and measure tissue elasticity throughout the rehab process
– More accurately visualizes myofascial trigger points
– Visualizes thickening or fibrosis of the fascia
– Monitors pre- and post-treatment elasticity for physical therapy, dry needling,
– injection procedures, shockwave therapy and more

Treatment Of Shin Splints

At NYDNRehab we use the most innovative approaches to treat and prevent tibial stress syndrome (aka shin splints).

Our methods include:

Identifying biomechanical overload using 3D gait analysis, including force plate technology and our instrumented treadmill, to help us identify the points in the gait cycle where excessive ground reaction forces occur
Sonoelastography to evaluate muscle elasticity, which is a decisive factor for treatment of shin splints.
Individualized gait-specific physical therapy
Running feedback retraining, using the only available system in NYC
Kineo intelligent load technology, to assess and retrain muscle imbalances in the lower kinetic chain

When biomechanics are the root cause of shin splints, treatment needs to be very specific to the individual patient and their biomechanical faults. Computerized gait and running analysis may be a treatment option.

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.

Physical therapy and rehab can be time consuming,

and a faulty diagnosis can make treatment a total waste of time.

Failure to accurately diagnose a condition in its early stages can lead to chronic
problems and sometimes devastating results

Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.

Below is a prime example of how ultrasound can take the guesswork out of diagnosis.

Learn more »

Accurate Diagnosis Is the ONLY way to

Successful Treatment

A bad physical therapy experience is one of the primary causes of unnecessary surgery

At NYDNR, we believe in

medical innovation

We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.