Far back, the term shin splints was used to explain basic pain in the lower leg, since lower leg pain was all lumped together and called shin splints– despite what or where the pain lay.
What are Shin Splints?
Today, we understand that shin splints occur in a specific area and are a separate diagnosis from other problems, such as stress fractures or compartment syndromes. Scientists and doctors are now more educated and are aiming to be more particular in calling causes of lower leg pain.
They likewise are attempting to base the name of the diagnosis on where the pain is located and by what is in fact causing the pain. Generally, the pain connected with shin splints is felt on the medial-posterior (inside-back) tibia. Therefore, shin splints are now called medial tibial stress syndrome.
There is still much dispute on what in fact causes the pain. Possible causes of the pain are: periostitis (inflammation of the covering around the bone), traction periostaligia (pain of the covering around the bone due to muscle pulling on it), tendinopathy (problems with the tendons), periosteal response (development of brand-new bone due to injury) and fatigue failure of the connective tissue linking muscle to bone.
The term “shin” is a common name for the big, lower leg bone called the tibia. If you take your hand and touch the front of your lower leg, the hard bone you feel is your tibia. Shin splints often impact people who run.
Shin Splints and Causes
- Running downhill.
- Running on uneven surface areas.
- Weak muscles in the front of the leg (stronger muscles in the back of your leg).
- Over-pronation (when your foot rolls to the inside and your arch flattens).
- Wearing inappropriate shoes (worn-out or inaccurate for your foot type).
- Training too hard too soon (not increasing your activity gradually), due to the fact that muscles that fatigue rapidly lose their ability to absorb shock and therefore more stress is put on the bones.
- Resuming activity (workout) after a period of no or lowered activity.
Other Causes of Lower leg Pain
- Compartment syndrome.
- Stress fracture.
- Bone growth.
- Vascular disease.
- Spinal stenosis.
- Nerve entrapment.
Symptoms and Signs of Shin Splints
- Tenderness over the inside shin area (might begin as a dull ache and progress to a sharp pain).
- Pain begins with activity then appears to vanish, but might return at the end of activity, as shin splints worsen the pain might last longer.
- Lower leg swelling.
- May see lower leg inflammation (rubor).
- May feel a lump or bump on the lower leg.
- Pain with toes or ankle pointed downwards.
How to Diagnose Shin Splints
The diagnosis is normally made from your history and physical exam. Pain is generally located 3-12 cm above the pointer of the within ankle bone (medial malleolus) and is “vertically oriented” (adds and down) rather than pain with a stress fracture, which is horizontal (throughout or side to side).
Your podiatrist or doctor need to carry out a biomechanical exam to see if your foot type is contributing to your shin splints. If the diagnosis is still uncertain, your doctor might buy an x-ray, MRI or bone scan. An MRI is able to show a difference in between shin splints and stress fractures: A stress fracture will show a “wide signal problem” whereas shin splints will show a “linear signal problem.”
Nevertheless, an MRI is typically not required if the physical exam findings are obvious. Often, a bone scan might be done, which can show a linear (long line) of increased signal uptake, highlighting the difference between shin splints and stress fractures.
How Treat Shin Splints
- Rest (no exercise).
- Ice/ice massage.
- Strengthen lower leg muscles in front of leg.
- Sports massage.
- Appropriate shoes.
- Arch supports.
- Orthoses (orthotics).
- Anti-inflammatories (NSAIDs).
- Physical therapy.
- Cross training (swimming, biking, walking).
- Train on softer surface area (soft yard, smooth dirt, asphalt, concrete).
- Relative rest (extending the time between exercises alleviating the amount and strength of the workouts).