Shin Splints

Shin splints

What are shin splints?

Shin splints is a term used to describe pain in the shins or anterior compartment of the lower leg.

How is it contracted?

The most common way in which shin splints is contracted is by participating in some form of vigorous athletic activity, such as long-distance running, sprinting, basketball or high-impact aerobics.

'Pain and swelling occur in the anterior compartment of the lower leg'.

Shin splints occur from over-training during an exercise programme, therefore the importance of the old adage 'train don't strain' cannot be over-emphasised. The splints are created when a person over-trains and the lower leg is unable to withstand the chronic stress placed on it.

What are the symptoms?

Symptoms of shin splints include a very intense aching pain right along the front of the leg accompanied by swelling. If the pain is ignored and the person persists in training they run the risk of further aggravation of the injury. Shin splints may result in stress fractures of the tibia or chronic tendonitis (inflammation of the tendons).

How is it diagnosed?

The first thing which must be determined by your GP is the type of shin splint which exists. This is done by checking for the site of pain. There are three main forms of shin splints:

  • Inflammation of the posterior tendon: The tendon involved runs down the leg and behind the inside anklebone before it hooks into the inside central portion of the arch. It belongs to a muscle called the posterior tibalis, whose function is to increase the impact when the foot strikes the ground. If a foot is excessively flat, there is a greater possibility of shin splints from over-exercising.
  • Inflammation of the anterior tendon: The tendon involved here is the anterior tibalis tendon, which runs down the front of the leg and goes into the top mid-portion of the arch. The muscle for this tendon is located on the upper outside of the shin. With this type of injury it is more common for the muscle to be involved rather than the tendon. A tight calf muscle usually causes anterior tibial shin splints. The injury occurs when the tight calf muscle limits ankle movement causing the foot to hit the ground with a great deal of force. The muscle tries to slow down the foot strike leading to muscle fatigue and eventual inflammation and pain.
  • Stress fracture shin splints: This type of injury normally involves the tibia (the large lower leg bone, which connects the knee and ankle). It is characterised by excessive pain when pressure is applied to the front of the bone. It can sometimes be difficult to detect and special x-rays may have to be taken to detect the exact location of the stress fracture.

How is it treated?

Shin splints are usually self-limiting once remedial action is taken in time. The first, and most obvious form of treatment, is to decrease daily activity levels. The inflamed area should be iced on a regular basis and over-the-counter anti-inflammatory medication can also be used.

If the patient is suffering from tendonitis, they may have to invest in prescription foot orthotics (shoe inserts) if they wish to continue exercising.

Stretching programmes are very effective in relieving the symptoms of anterior tibial shin splints, which is caused by a tight calf muscle.

Stress fractures take longer to heal than either of the other two types of shin splints. All forms of exercise must be discontinued until the pain and inflammation subsides and very careful attention must be paid to the type of shoes worn for exercise. Occasionally, stress fractures may become chronic, requiring specialist orthopaedic referral for further management.

Can shin splints be prevented?

The most important factor in the avoidance of shin splints is proper footwear. Good arch support is essential, particularly for high-impact exercise. Warming-up and stretching before participating in vigorous exercise is also a very important factor in avoiding shin splints. Trying to do too much too fast can also cause injury, so the key is to take things slowly.

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