SHIN SPLINTS
DEFINITION:
- Also known as ” Periostitis” and “Medial tibial stress syndrome”.
- An inflammatory process involving the sheath of tissue surrounding the bone (periosteum). (See illustration).
MECHANISM OF INJURY / HOW IT OCCURS:
- A result of a traction force of muscle on periosteum of bone, leading to small tears to the muscle and subsequent inflammation. (See illustration).
- Often a result of cumulative stress and trauma.
- Running on hard surfaces, wearing worn athletic shoes, increasing mileage quickly, overtraining, as well as poor warm up and stretching, are all causes of shin splints.
SYMPTOMS:
- Pain over the inner (medial) lower leg usually spanning several inches.
- Weight bearing activities such as running and jumping exacerbate the symptoms.
- Symptoms may persist after the activity.
DIAGNOSIS:
- Physical examination will reveal tenderness over affected area. May see swelling, however inconsistent.
- Beware of possible STRESS FRACTURE or COMPARTMENT SYNDROME.
- Radiographic evaluation may be considered especially for persistent symptoms. ( X-ray, bone scan, MRI).
TREATMENT/REHABILITATION:
- Rest, ice, and anti-inflammatory medications (NSAIDs) are indicated.
- Proper shoe wear/insoles. (See recommendations under footwear for runners).
- Physical therapy to include strengthening and stretching. (See exercises for shin splints).
- Activity modifications to include decreased mileage or stopping altogether if symptoms are severe.
- Cross training – swimming, cycling, elliptical machines, etc.
- Importance of a gradual return to activity must be stressed. Avoid a rapid increase in distance running.