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Shin Splints
Definition
The lower leg pain resulting from shin splints is caused by very small tears in the leg muscles at their point of attachment to the shin. There are two types:
1. Anterior shin splints occur in the front portion of the shin bone (tibia).
2. Posterior shin splints occur on the inside (medial) part of the leg along the tibia.
Anterior shin splints are due to muscle imbalances, hill or stair running or toe running. Posterior shin splints are too poor shock absorption, pronation and worn out shoes. Excessive pronation and overtraining can contribute to both anterior and posterior shin splints.
Symptoms
The pain may begin as a dull aching sensation after running. The aching may become more intense, even during walking, if ignored. Tender areas are often felt as one or more small bumps along either side of the shin bone. Pain is often felt at the beginning of a run but may subside after 1-2 miles. This can falsely make one believe that they can run through the pain.
Causes of Injury
· Tightness in the posterior muscles, which propel the body forward, places additional strain on the muscles in the front part of the lower leg, which work to lift the foot upward and also prepare the foot to strike the running surface.
· Hard surface running, or worn or improper shoes increases the stress on the anterior leg muscles. Softer surfaces and shoe cushioning materials absorb more shock and less is transferred to the shins.
· The lower leg muscles suffer a tremendous amount of stress when a runner lands only on the balls of the feet (toe running and hill training), without the normal heel contact.
· The muscles of the foot and leg overwork in an attempt to stabilize the pronated foot and the repeated stress can cause the muscles to tear where they attach to the tibia.
· Rapid increase of speed or distance.
Short Term Treatment
· Ice immediately after running, never before.
· Aspirin, naprosyn or ibuprofen, to reduce inflammation and relieve pain.
· Reduce mileage and intensity for 7 to 10 days; never run through pain.
· Avoid hills and hard running surfaces.
· A varus wedge or stability/motion control running shoes to support the inside of the foot and reduce the amount of pronation.
· Gentle stretching of the posterior leg and thigh muscles.
Self-enforced treatment of shin splints, as with most overuse injuries, is successful in most cases.
Long Term Treatment
Persistent problems may warrant a visit to Dr. Morris who may prescribe the following treatments:
· Strengthening and flexibility programs to correct muscle imbalance. These exercises should only be done in the absence of pain.
· Custom functional foot orthotic device.
· Shoe recommendations
· Anti-inflammatory medications (Celebrex, Vioxx)
· Physical therapy consultation involving ice massage, ultra-sound, electrical stimulation, stretch and strength traininig and heat to reduce inflammation and pain.
The best means of prevention of serious athletic injuries is to maintain good muscle strength and flexibility.
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