Shin splints or pain in the shin muscles (medically known as medial tibial stress syndrome) is a very common injury that causes pain over the shin bone – this condition is very common to sprinters. This condition generally occurs owing to arduous exercise following a period of comparative inactivity. In effect, there are four types of shin splints – tibial periostitis, posterior tibial shin splints, stress fractures and anterior compartment syndrome.
While the bone is itself sensitive and sore in tibial periostitis, people enduring posterior tibial shin splints experience pain in the front part of the leg. In fact, posterior tibial shin splints comprise as much as 75 per cent of all shin splints among the athletes. On the other hand, stress fractures result in intense pain accompanied by tenderness in the region about 1 inch to two inches (2.5 cm to 5 cm) lower than the knee.
It may be noted that apart from the leg, stress fractures may occur in different parts of the body too. The anterior compartment syndrome has an effect on the external part of the front side of the leg.
Generally, when one suffers from shin splints or pain in the shin muscles, he/ she experiences pain in the front of the outer leg a little lower than the knee. Typically, the pain occurs on the external edge of the middle part of the leg close to the shinbone (also called tibia). They frequently experience a constant uneasiness in an area measuring about 4 inches to 6 inches (10 cm to 15 cm) in the same place.
In fact, one experiences pain in the initial part of undertaking exercises and subsequently reduces. However, it reappears sometime around the end of the training session. Often, the discomfort caused by shin splint is depicted as bland initially. But, as the ordeal continues, it is possible that the pain would become so intense that it may even compel the athlete to stop all his/ her workouts completely.
What causes shin splints?
Since shin splints are related to the injuries to shin muscles, the primary cause of developing this condition is also an abrupt enhancement either in the distance or intensity of a training/ exercise schedule. Such an increase in muscle activity is likely to be related to inflammation of the lower part of the leg muscles, which are used to lift the foot – the movement during which the foot turns in the direction of the tibia.
This situation can easily be worsened owing to a propensity to rotate the foot inward in the form of an arch (pronate the foot). Likewise, a rigid Achilles tendon or feeble ankle muscles too are frequently associated with the development of shin splints or pain in the shin muscles.
A number of risk factors are associated with shin splints and some of these are mentioned here. People with flatfeet or unusually inflexible arches are prone to develop shin splints. In addition, strenuous activities, such as running or jogging, dancing, military training may also result in shin splints. Most importantly, any sudden enhancement in training/ exercise or undertaking new forceful impact training may also cause shin splints.
Diagnosing Shin Splints
Normally, shin splints are diagnosed by undertaking various examinations. In effect, the diagnosing of shin splints largely hinges on a cautious assessment of the patient’s medical history as well as concentrated physical tests – usually on checking the shins and legs where local inflammation is observed.
Specialized, and often expensive, examinations, for instance, scanning of the bone, are usually required only if the diagnosis made by the above-mentioned methods do not provide a clear picture of the condition. In this situation, radiology tests, for example, X-rays, MRI scan or bone scan, may also prove to be useful to find out the stress fracture of the tibia. It may be noted here that a bone scan is akin to an X-ray, except for the fact that it uses gamma rays.
Treatment of shin splints
There are various ways by which you may treat shin splints or pain in the shin muscles. They include self-treatment, non-surgical treatment and surgery. Each of these methods is discussed in brief below.
If you are trying self-treatment for shin splints, first of all you ought to give some respite to your injury and mull over what could have been the reason for developing the shin splint. In addition, you may use over-the-counter (non-prescription) drugs like ibuprofen, which would help to lessen the pain as well as inflammation.
However, before using any medication, read the patient information leaflet available with the medicine meticulously and follow the instructions strictly. In case you have any problem in understanding any part of the literature or are not sure how to use the medication, you may talk to your pharmacist for help in this regard.
At the same time, you need to examine your sports or training shoes to be sure if they provide you sufficient support and comfort – cushioning. If you are unable to decide on or ascertain things, visit a specialist running shop and they would be able to counsel you as well as provide information regarding your trainers. In fact, any experienced adviser will first watch you run and then suggest the shoes most suitable for you.
In addition, it is also essential for you to contemplate regarding the extent of exercise you are doing and if it is the reason behind developing shin splints. If you find this to be true, you may have to lessen the amount of exercise you are doing currently and reschedule your training program.
If you feel that you need to change your training schedule, you should visit a physiotherapist. It may be noted here that a physiotherapist is basically a health professional who focuses on movement and mobility. A physiotherapist is the best person to help work out a regulated training schedule to support your recovery from shin splints as well as help you to resume your normal sporting activities.
Precisely speaking, a physiotherapist can help you in several ways. While he/ she is able to help you to reinstate any loss of range to the lower limb joints and muscles that may be responsible for the development of shin splints, they are also the best people to advise you on a reinforcing program – particularly for the calf muscle. If required, your physiotherapist may also use various modes of treatment, such as acupuncture, tape or soft tissue methods, to help alleviate the pain and inflammation caused by shin splints.
In addition, you may also visit a podiatrist – a healthcare professional who is focused on medical conditions affecting the feet. The podiatrist would be able to advise you regarding foot care. If required, the podiatrist may also provide you with shoe inserts called orthotics with a view to regulate the inward roll of your feet.
If you have developed shin splints as a result of compartment syndrome and are experiencing intense pain, your doctor is likely to suggest you to undergo an operation, known as fasciotomy. Undergoing this surgery helps to let loose the pressure on the muscles in the lower portion of the leg. You may also consult your general physician or physiotherapist for further details in this regard.
If you desire to treat your shin splints in a proper manner and also prevent them from developing again, it is important that you should first consider the causes that have actually led to this medical condition. Irrespective of the amount of rest you give your injury, the anti-inflammatory medications you use or the frequency of massages you take, all the symptoms of this medical condition are likely to keep on reoccurring if you do not correct the cause behind the development of the shin splints.
It is possible to rectify overpronation (excessive inward movement of a body part, especially a rolling inwards of the foot) and supination (an analogous foot motion comprising adduction followed by inversion), which are basically biomechanical problems, by using the correct running shoes or insoles (orthotics). It is vital to ensure that the sports shoes or trainers you are using are suitable for your foot as well as the nature of activity you are engaged in.
As far as running is concerned, the generally a reliable practice is not to augment the distance more than 10 per cent in a week. For instance, if you complete a distance of 10 miles in a week, you should not increase the distance to more than 11 miles in the subsequent week. By following this time-tested method, you will be able to ensure that you are not overworking your muscles all of a sudden.
In fact, runners should always avoid running on hard surfaces, such as pavements, since they do not provide any shock absorption to the body. Therefore, from time to time, runners should try running on other different surfaces, such as on tarmac, grass and also sand, with a view to lessen the shock that may have passed through their legs.
Often shin splints may also develop owing to excessively firm muscles in the lower part of the leg, including the calf muscles (gastrocnemius and soleus) as well as the shin muscles. Moreover, if you undertake stretching every day regularly and also receive sports massage, both are able to facilitate in improving the flexibility of the muscles.
Supplements and herbs
Apart from over-the-counter drugs and surgery, a number of herbal products are also known to be effective in treating shin splints. For instance, you may massage the fractured area with a few drops of andiroba oil, which possesses anti-inflammatory properties, and helps to ease pain and inflammation. Alternately, you may also apply arnica cream on the affected area once or twice every day, as it helps to prevent the discharge of hormones that cause pain.
Nevertheless, you ought to adopt a few precautions while using these herbal products. You should never apply arnica on the broken skin or to an open wound. In case you develop any rash while using the arnica cream, discontinue it immediately. It is important to remember that pregnant women should never use arnica.
Additional things you may do
In addition to using medications and/ or surgery, you may do some additional things to treat shin splints. In fact, if you develop any of the two types of tibial shin splints, you ought to avoid running for two to four weeks. You may also apply ice on the affected area for about 20 minutes two times every day for a week. This will help to alleviate pain and swelling.
If you have developed anterior compartment syndrome, you need not stop your exercises altogether. However, it is necessary to warm up as well as cool down in an appropriate manner. In addition, if necessary, you might have to reduce the number of miles you have been running when you developed the medical condition. Generally, the pain settles as the muscles get adjusted to vigorous work-outs. However, if you still experience the pain, it is advisable to consult a doctor.
On the other hand, if you have developed stress fractures, you need to relax the area for no less than a month. If it is essential, you may also use crutches for walking. However, take care not to put any stress on the affected area even while you are walking with the help of crutches.