by Robert J. Snyder MD
Every runner’s nightmare is the pain known as shin splints. Shin splints, which develop along the inner edge of the shinbone (tibia), are a common exercise problem that is often related to doing too much, too soon. Also known as medial tibial stress syndrome, shin splints occur when the muscles, tendons and bone tissue become inflamed around the tibia. The pain caused by shin splints is not so much an injury as it is stress on the muscles, tendons and joints in the lower leg.
Most commonly, shin splints develop in your dominant leg (If you’re right-handed, you are right-footed most likely). Shin splints develop as the muscles in the leg are overworked by repetitive activities. Sudden changes in physical activity such as increased duration, intensity, days per week of exercise, or inclined workouts can cause pain in the shins. Other factors that may cause shin splints are having flat feet or wearing inappropriate footwear when exercising.
Although not as common as shin splints in the medial area of the lower leg, anterior shin splints, which occur along the outer edge of the shinbone, often to happen to those who don’t stretch prior to exercise or are not adjusted to the physical stresses they are enduring.
Sometimes shin pain is incorrectly diagnosed as shin splints when another issue is causing the pain. Compartment syndrome occurs in the outer part of the leg and creates pressure due to swelling muscles within a contained space. Pain in this area could also be a stress fracture, which is much more serious than shin splints. Stress fractures are a partial crack in the bone, and have a precise point of pain, unlike shin splints which create a more widespread pain throughout the lower leg. If it is suspected after a physical examination that you may have an injury such as a stress fracture, an x-ray or bone scan can confirm the diagnosis.
The typical treatment method for shin splints is rest. Take a break from the activity that is causing the shin pain for several weeks.
Wearing supportive shoes or orthotics can reduce stress in the shins. Orthotics are shoe inserts that are custom made for each patient, and help stabilize the lower leg when exercising or through daily activities. Pain medications such as ibuprofen and aspirin, ice, and compression bands can all be used as well to reduce shin pain.
When returning to exercising, do so at a gradual pace. Exercise routines should be less intensive and not as often as before the shin pain. Stretch thoroughly before you begin, and if you start to feel pain, stop physical activity right away.
There are certain prevention methods that can be taken to prevent a shin splint, or avoid another from occurring. One of the most important steps is to make sure to wear the correct type of shoe for your sport or exercise regimen. Some athletic stores will analyze your foot type and suggest certain brands and shoe types for you. Make sure to build your fitness level at a gradual pace and not jump into an intense, long workout that your body can’t handle. Cross training can help your body condition itself overtime by doing less vigorous exercises intermittently, and puts less strain on the body. Proper stretching and warm up before physical activity is advised, as well as avoiding hard, rocky terrain.