What are shin splints?
The term shin splints is a name often given to any pain at the front of the lower leg. However, true shin splints symptoms occur at the front inside of the shin bone and can arise from a number of causes.
The most common cause is inflammation of the periostium of the tibia (sheath surrounding the bone). Traction forces on the periosteum from the muscles of the lower leg cause shin pain and inflammation. This has lead to the use of terms such as Medial Tibial Traction Periostitis.
Symptoms of shin splints:
- Pain over the inside lower half of the shin.
- Pain at the start of exercise which often eases as the session continues
- Pain often returns after activity and may be at its worse the next morning.
- Sometimes some swelling.
- Lumps and bumps may be felt when feeling the inside of the shin bone.
- Pain when the toes or foot are bent downwards.
- A redness over the inside of the shin (not always present).
Shin Splints Treatment
Treatment for shin splints is as simple as reducing pain and inflammation, identifying training and biomechanical problems which may have helped cause the injury initially, restoring muscles to their original condition and gradually returning to training.
What can the athlete do about shin splints?
- Rest to allow the injury to heal.
- Apply ice or cold therapy in the early stages, particularly when it is very painful. Cold therapy reduces pain and inflammation.
- Stretch the muscles of the lower leg. In particular the tibialis posterior which is associated with shin splints.
- Wear shock absorbing insoles in shoes. This helps reduce the shock on the lower leg.
- Maintain fitness with other non weight bearing exercises such as swimming, cycling or running in water.
- Apply heat and use a heat retainer or shin and calf support after the initial acute stage and particularly before training. This can provide support and compression to the lower leg helping to reduce the strain on the muscles. It will also retain the natural heat which causes blood vessels to dilate and increases the flow of blood to the tissues to aid healing.
- Visit a sports injury clinic for treatment and rehabilitation.
What can a sports injury clinic or doctor do?
- Prescribe anti-inflammatory medication e.g. ibuprofen (always consult a doctor before taking medication).
- Tape the shin for support - A taping worn all day will allow the shin to rest properly by taking the pressure off the muscle attachments.
- Perform gait analysis to determine if you overpronate or oversupinate.
- Use sports massage techniques on the posterior deep muscle compartment but avoid the inflamed periostium close to the bone.
- Operate (this is rare).
Causes
Shin splints can be caused by a number of factors which are mainly biomechanical and errors in training. Here are the most common causes:
- Overpronation of the feet
- Oversupination of the feet
- Inadequate footwear
- Increasing training too quickly
- Running on hard surfaces
- Decreased flexibility at the ankle joint
Prevention
In order to properly treat shin splints and prevent them recurring, the causative factors must be taken into consideration. No matter how much rest, anti-inflammatories and massage are used, without correcting the cause of the injury, the symptoms will continue to return.
Biomechanical problems such as overpronation and supination can be corrected using running shoes or insoles (or orthotics). Ensuring shoes/trainers are suitable your foot type and for the activity in question.
As a rule of thumb with running, distances should not increase by more than 10% per week. For example, if you complete a total of 10 miles one week, do not increase above 11 miles the next week. This helps to ensure the muscles are not overworked.
For runners, try to avoid always running on hard pavements as they provide no shock absorption. Try running some of the time on tarmac, grass or even sand to reduce the shock passed through the legs.
Shin splints can be caused by overly tight muscles in the lower leg, including the calf muscles (gastrocnemius and soleus) and the shin muscles. Stretching on a daily basis and even receiving sports massage can help improve flexibility.
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