Pain in the front part of the lower leg / “shin” area. Pain in this area is often referred to as “shin splints”. Sometimes these are referred to as “ Medial tibial Stress Syndrome” These pains are often exercise related or from overuse.
Why / How does this happen?
Typically occurs from overuse. It is commonly associated with runners especially those whom increase their intensity / distance or terrain.
Over- pronation “over flattening” of the foot can also lend to the development of shin splints. Excessive pronation and flatfeet can increase stresses on the lower leg muscles.
Over-pronation may be flexible or inflexible. It can be functional or as a result of poorly supportive shoes / worn out shoe gear.
What are the symptoms?
Shin splints develop when the muscle at the bone / muscle interface (periosteum) is over-worked in repetitive activity resulting in various symptoms, which include sharp, razor like pain or dull aching, throbbing pains. It may occur during or after activity. Pain usually occurs along the shin bone (along the tibia).
Why should I see a Doctor for examination?
There is risk of shin splints propagating to a stress fracture of the tibia. Stress fracture is a small crack in the bone typically from overuse.
Your doctor will also rule in or rule out Tendonitis, and chronic exertional compartment syndrome. Tendonitis occurs when the tendons become inflamed often due to over use. Chronic exertional compartment syndrome is an uncommon, yet painful condition in which pressure within the muscle builds to dangerous levels during exercise. This pain generally subsides when the activity stops.
Your doctor will examine you and order radiographs initially and sometimes advanced imaging is warranted such as bone scan or MRI.
What can I expect from treatment options?
- Rest, Ice, elevation for symptom management.
- Ice is generally recommended to be applied for 20 minutes several times a day.
- NSAIDS (Nonsteroidal anti-inflammatory drug) can help in reducing pain and swelling.
- Appropriate shoe gear, orthotic devices- help to stabilize the foot and decrease the over use of the associated tendons / muscles.
- Gradual return to activity after a few weeks of full resolution of symptoms. It is often recommended to return to a lower intensity level and gradually increase as tolerated.
The good news is shin splints usually resolve with conservative care and time.