According to the American Medical Association, shin splints is the pain or discomfort felt in the leg as a result of frequent running on hard surfaces or excessive application of force on foot flexors. Shin splint is a collective term used to describe any pain felt on the shin bone. It is commonly referred to as medial tibial stress syndrome (MTSS) by medical personnel. Pain caused by shin splints is usually felt on the lower leg between the knee and the ankle. A person engaging in moderate to strenuous physical activity is at a higher risk of experiencing this pain. It is a usually common problem affecting soldiers and athletes as they mostly engage in strenuous physical activities. At times, the pain is too intense that one is forced to stop the strenuous physical activity. Incessant strain on both the mandibles, muscles, and joints on the lower leg implies that the body is not able to undergo natural restoration and healing ("The Real Reason You Have Shin Splints").
How can you tell if you have shin splints? Usually, shin splint injury manifests as tenderness on the lower leg which recedes during rest but worsens during exercise or any other weight bearing activity. As shin splint progresses, the pain felt can be caused by even the slightest of activities. At times, swelling may be experienced on the lower side of the tibia.
Causes of shin splints
Medial tibial stress syndrome has no singular cause. It is caused by both intrinsic and extrinsic mechanisms. The causes are well stated below:
Tibialis posterior: muscle tearing away from the bone can be a plausible cause of shin splints.
There is, however, some doubt with regards to this cause as the location of the muscle origins is some considerable distance from the location where the pain caused by shin splint was felt.
Soleus: Shin splints can be caused by excessive elongation of the soleus, which is part of the larger calf complex as it contracts eccentrically with foot pronation.
Periostitis: this is the inflammation of the muscles surrounding the tibia. Essentially, shin splint comes about as a result of a stress fracture.
Lack of flexibility has also been traced to cause shin splints.
Improper training techniques can also MTSS
Weak muscles in the buttocks or thighs
Abnormalities in the anatomy such as the flat foot syndrome
Excessive pressure on the shin can be caused by running on uneven terrain, use of inappropriate shoes for running or exercising, engaging in a sporting activity that involves fast starts and stops.
Symptoms of shin splints
People suffering from shin splints will exhibit some of the following symptoms:
At times, a dull ache might be experienced on the front part of the lower leg.
Pain felt on either side of the shin bone
Feeling pain in the lower leg when exercising
Feeling numb and weak on the lower leg
Feeling a painful sensation on the inner part of the lower leg
Mild swelling of the lower leg ("Shin Splints Symptoms - Mayo Clinic")
Lower leg pain does not however necessarily mean that it is a diagnosis for shin splints. Most common differential diagnosis for MTSS includes stress fractures and compartment syndrome. As a runner, it is not advisable to run through the pain until you have ruled out these differential diagnoses. Stress fractures are more likely to indicate some tenderness along the tibial bone. If you suspect a stress fracture, it is advisable that you take a rest to allow for renewal and healing of the bone. Compartment syndrome occurs when there is a buildup of pressure in one of the fascial compartments in the lower leg. Compartment syndrome should be treated as a medical emergency as it causes increased pressure within the limb, causing a reduction in blood and oxygen supply to the tissues.
Diagnosis of shin splint
The best way to diagnose MTSS is by ruling out all other differential diagnoses, including stress fractures and compartment syndrome. Health care professionals can also undertake objective and subjective examinations as part of the diagnostic procedure. Imaging tests including bone scans and MRIs are the commonest.
Treatment of shin splints
Shin splints usually require that one should take a break from strenuous exercise or activity. The discomfort usually fades within a few hours or days with adequate rest and limited physical activity. A two week period is usually recommended to allow the lower leg to heal. At this period of break, one can engage in sporting activities that are less strenuous such as swimming or taking walks. Doctors usually recommend that one should keep their legs at an elevated position, using an ice bag to reduce the swelling, taking an over the counter medication so as to reduce the pain and putting on of elastic compression bandages. It is also recommended that one should warm up before engaging in an exercise to ensure that the legs are not sore. Always consult with your doctor before you resume your exercise routine.
Shin splint rarely require the application of surgical procedures. Compartment syndrome might, however, necessitate surgical procedures to open the fascia. A muscle tear from the shin bone might also require surgery so as to reattach the muscle.
Prevention of shin splints
Prevention is always better than cure. You can always take certain steps to minimize chances of being affected by shin splints. Such steps include:
Putting on good fitting shoes that offer proper support
Putting on in soles capable of absorbing shock
Not exercising on terrains that are uneven or hard
Not exercising through the pain
Gradually increasing the intensity of the exercise
Warming up before engaging in an exercise
Ensuring that you engage in strength training; specially focusing on toe exercises that strengthen the calf muscles.
Proper stretching during and after exercising
An intense exercise program requires the strengthening of all the surrounding muscle groups. A proper balance should be achieved to ensure that no particular area receives excessive stress. You should refrain from continuing with exercise or training if severe muscle pain or other symptoms are experienced ("The Truth About Shin Splints").
The cause of shin splints is still foggy in the medical fraternity. This perhaps explains why it is difficult to prescribe an accurate diagnostic or even treatment measure for the condition. It is worth to preclude than to treat, that is why it is important to vary your running surface, though not abruptly, and putting on well-fitting and comfortable shoes when exercising. In case you develop MTSS, it is advisable to take a break from the exercise routine and incorporating other non-weight bearing exercises in your regime. It is wise to identify MTSS risk factors to help you avoid break ups in your exercise routine.
"The Truth About Shin Splints". Run3d.co.uk. N.p., 2013. Web. 7 May 2016.
"The Real Reason You Have Shin Splints". Men's Journal. N.p., 2016. Web. 7 May 2016.
"Shin Splints Symptoms - Mayo Clinic". Mayoclinic.org. N.p., 2016. Web. 7 May 2016.
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