Orthopedic Diseases
Shin Splints

Overview:

  • Shin splint refers to an inflammation of the muscles, tendons, and bone tissue around your shin.  
  • You get shin splints from overloading your leg muscles, tendons or shin bone.
  • Simple measures can relieve pain alongside with rest, ice, and stretching. 
  • The most common symptom of shin splints is pain along the borders of your shin.
  • Mild swelling may also occur in the area.
  • You should not overdo your exercise routine. 

What are shin splints?
Shin splints occur when you have pain in the front of your lower leg. The pain of shin splints is from the inflammation of the muscles, tendons, and bone tissue around your shin. Shin splints are a common problem for runners, gymnasts, and military recruits. However, there are things you can do to heal from shin splints and prevent them from getting worse.

Other names: Medial tibial stress syndrome;  exercise-induced leg pain

Cause:
Shin splints happen from overuse of legs, tendons, and leg bones, with too much activity or an increase in training. Most often, the activity is high impact and repetitive exercise of your lower legs. Shin splints often occur after abrupt changes in your usual physical activity.

Common activities that cause shin splints are:
  • Running, especially on hills;
  • Increasing your days of training;
  • Increasing the intensity of training, or going a longer distance;
  • Doing exercise that has frequent stops and starts (e.g. basketball or military training).

Risk factors:
  • Having flat feet or very rigid foot arches;
  • Working out on hard surfaces (e.g. running on the street or playing basketball or tennis on a hard court);
  • Wearing improper or worn out shoes.​

Symptoms:
  • Pain in one or both legs;
  • Sharp or dull, aching pain in the front of your shin;
  • ​Mild swelling in the area;
  • Pain when you push on your shins;
  • Pain that gets worse during and after exercise;
  • Pain that gets better with rest;
  • If you have severe shin splints, your legs may hurt even when you are not walking.

When to see a doctor?
  • If you have severe pain or pain that doesn’t go away even with a few weeks of rest;
  • If you have regular shin pain;
  • If you notice swelling in your lower legs or that your shin is red and feels hot to the touch;

Complications:
It is rare for shin splints to result in complications. However, when you continue running or exercising without allowing your legs to rest, shin splints can develop into a stress fracture. This occurs when tiny cracks form in the bone. 

Diagnosis:
The diagnosis includes discussing your symptoms and medical history, with your doctor. He will also examine your lower leg. Sometimes, other problems may exist that can have an impact on healing. Your doctor may order additional imaging tests to rule out other shin problems. 

Treatment:
Decrease your activity: 
  • Expect that you need at least 2 to 4 weeks of rest from your sport or exercise.
  • Avoid repetitive exercise of your lower leg for 1 to 2 weeks. Keep your activity to just the walking that you do during your regular day.
  • Try other low impact activities as long as you do not have pain, such as swimming or cycling).
  • After 2 to 4 weeks, if the pain is gone, you can start your usual activities. Increase your activity level slowly. If the pain returns, stop exercising right away.  
Know that shin splints can take 3 to 6 months to heal. Do not rush back into your sport or exercise. 

Reduce your pain and swelling:
Following are tips to ease discomfort:
  • Ice your shins. Ice several times a day for 20 minutes every day. Do this for 3 days or until pain is gone. Avoid putting the ice directly on your shin.
  • Do stretching exercises.
  • Take NSAIDs (such as:  ibuprofen, naproxen, or aspirin) to decrease swelling and to help with pain. Know these medicines have side effects and can cause ulcers and bleeding. Talk to your doctor about how much you can take.
  • Use arch supports. Talk with your doctor and physical therapist about wearing the proper shoes, and about special shock-absorbing insoles or orthotics to wear inside your shoes.
  • Work with a physical therapist. They can use therapies that may help with the pain. They can teach you exercises to strengthen your leg muscles. 
Surgery: 
Very few people need surgery for shin splints. Surgery has been done in very severe cases that do not respond to nonsurgical treatment.

Prevention:
  • Put on proper athletic shoes. Look for athletic shoes that match your particular foot pattern.
  • Make sure you wear shoes designed for your sport.
  • Add low-impact sports to your exercise routine (such as: Swimming or cycling) to give your legs the chance to rest. 
  • Slowly build your fitness level. Increase the duration, intensity, and frequency of your exercise regimen gradually. Avoid doing this suddenly. 
  • Do warm ups before your exercise. 
  • Avoid hard, uneven, or sloped surfaces when running.
  • Get enough rest between your exercises to give your muscles and bones time to heal. 
FAQ:
  • Do running shoes have a specific duration of use?
    • Running shoes lose over half of their shock absorbing ability after 250 miles (400 kilometers) of use. 

Myths & Truths:
  • Shin splints are chronic.
    • Truth: Shin splints are not chronic. 
  • When you have shin splints, you must stop exercising altogether. 
    • Truth: You can go back to excising once your shins heal, but only if:
    • You don’t feel pain for at least 2 weeks before you go back to your exercise routine. 
    • You avoid overdoing your exercise routine to prevent the pain from coming back. 
    • You start slow and make the duration of your exercises shorter. You can increase duration gradually. 
    • You stretch and warm up before and after exercise. 
    • You ice your shins after working out to reduce swelling. 
    • You avoid hard surfaces. 
    • You wear proper padded shoes that give you good support. 
    • You add low impact sports to your routine (such as: Swimming or cycling).
  • You continue exercising even if you feel leg pain. 
    • Truth: If you feel leg pain, reduce the level of your activity until you feel better. Avoid extra effort when you feel pain.

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