Shin Splints

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Man holding his lower leg, possibly experiencing shin splint painIf you find your shins aching after each workout run or game of basketball, you could be suffering from shin splints. It is an injury caused by stress on your shinbone (tibia) and the tissues that connect your shin muscles to that bone. Another name for this injury is medial tibial stress syndrome. It is a repetitive stress injury that appears over time and is not the result of a specific incident.

In this post we will describe the causes of this condition and the risk factors that increase your likelihood of developing the condition.We will then go on to describe the diagnosis and treatment for shin splints. We will finally make some suggestions as to how you might be able to avoid developing this painful and unpleasant condition.

Shin Splints – Cause & Risk Factors

Cause

Shin splints are the result of repetitive high impact physical activity (such as activity involving running and/or jumping) that sends shocks through the tibia (or shinbone) of your lower leg. These shocks cause trauma to the lower leg muscles and the result is inflammation of these muscles and the tissues connecting them to your tibia (shinbone). The inflammation then causes lower leg pain as well as possible swelling and tenderness in the same region.

Shin splints frequently appears after a sudden increase in the intensity of your exercise routine. This could be an increase in the number of miles you run each day or additional time spent on the basketball court, for example.

Risk Factors

There are several potential factors that may increase your risk of developing shin splints. It is beneficial to know what these factors are. Armed with this knowledge, you can take steps to reduce the intensity of the symptoms or even possibly to avoid the condition altogether.

The risk factors that increase your propensity to develop shin splints include:

  • Suddenly increasing the intensity or frequency  of your exercise sessions, particularly when those sessions involve plenty of high impact activity like running or jumping
  • In addition to runners, dancers sometimes have a tendency to develop shin splints;
  • Recent military recruits sometimes develop shin splints. This could be a reaction to suddenly spending long hours running and marching as part of their “basic training”;
  • Having flat feet (or foot arches that collapse when you take a step). Podiatrists call this “foot over-pronation”;
  • Working out in shoes that have inadequate cushioning from ground shocks or that don’t provide adequate arch support. Old or worn out shoes are examples of this;
  • Not including warm up or cool down sessions in your workouts;
  • Having weak ankles or underdeveloped hip or core muscles.

Symptoms Of Shin Splints

As mentioned earlier, the primary symptom of shin splints is pain and swelling along the front of your lower leg (shin). The pain will likely be concentrated along the inner edge of the shin.

Along with this primary symptom, you may observe that:

  • The pain persists both during and after your exercise session;
  • It is painful to even touch the injured area of your lower leg.

If you are experiencing these symptoms, it may be time to see a doctor (ideally one with a sports medicine background) for a diagnosis and treatment recommendation.

Diagnosis & Treatment Of Shin Splints

Diagnosis

To make a diagnosis, your doctor will need to conduct a physical examination of your lower leg. He or she will need to understand the nature of the pain you are experiencing, such as when and where it occurs.

It will be important for the doctor to determine whether three other conditions are also present. These are stress fractures, tendinitis and chronic exertional compartment syndrome. They each produce symptoms that are similar to shin splints, but may require different treatment:

To detect the presence of stress fractures (miniature cracks in the tibia), the doctor may request an MRI scan. This scan can also help to reveal the presence of tendinitis.

If the doctor suspects that you also have chronic exertional compartment syndrome, he or she may need to measure your intramuscular lower leg pressure before and during exercise in order to confirm this. That condition increases the pressure inside your muscles in response to running or jumping activity and causes severe lower leg pain. However, unlike shin splints, that pain usually goes away once you complete your exercise session.

Treatment

If your doctor concludes that you do indeed have shin splints, (s)he will most likely suggest a conservative (non surgical) approach for its treatment. This will likely include:

  • Resting for a period to allow your shin splint injury to heal;
  • In addition to rest, ice your shin for periods of 20-30 minutes every 2-3 hours. As an alternative to ice, you may use a cold compress;
  • Using anti inflammatory medications like Advil for extra control of pain  and inflammation;
  • Wearing a compression shin splint or compression sleeve on your lower leg. The compression will enhance blood flow through your lower leg and help to accelerate healing of injured tissues;
  • Switching to footwear with shock absorbing insoles (or using these insoles with your existing shoes);
  • After resting for a couple of weeks, and if the pain has gone, you can resume your workouts . However, you should increase your exercise intensity only gradually and be careful to warm up properly before each session. Stop exercising immediately if your shin splint pain returns.

How To Prevent Shin Splints

With such an unpleasant condition, it is obviously better to avoid shin splints if at all possible. To do this, we would suggest the following:

  • Cross train by interspersing high and low impact forms of exercise. Low impact exercise activities can include swimming and cycling, for example. They will allow you to maintain your fitness level without increasing your exposure to shin splint injury;
  • Be careful to use shoes for your exercise that have proper shock absorption and arch support;.
  • Try to warm up and cool down properly before and after each exercise session;
  • Increase training intensity gradually and allow your body to get used to the new level before the next increase.

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