The term “shin splints” refers to a group of problems that manifest as pain down the front of the lower leg between the knee and the ankle. This pain is usually exacerbated by exercise and eases with rest. People who are on their feet for long periods, who partake in long distance runs and people who wear inappropriate footwear are more predisposed to the condition but occurrences have been recorded in a wide variety of sports, in dance and in general activity.
Of this group of pathologies medial tibial stress syndrome (MTSS) is the most common accounting for an estimated 15% of all running injuries. It’s an overuse injury identified by pain down the inside of the shin. It usually follows a pattern in the initial stages of pain at the start of exercise which eases as the exercise goes on and returns once the exercise is over. As the condition progresses, the pain can be present for the duration of the exercise, eventually making it impossible to exercise at all. This condition affects women more than men and can arise for a variety of reasons including taking on too much activity too quickly, incorrect footwear, exercising on hard surfaces and biomechanical problems. Treatment for this condition involves rest from the exercise that causes pain, correction of foot position if required, massage and stretching of the leg muscles, and icing with or without anti-inflammatories to settle inflammation.
Stress fractures are another cause of shin pain and occur in bones that are subjected to repetitive trauma to an extent that causes the bone to fail. What happens is that the bone cells are broken down at a faster rate than the body can lay down new ones and, over a period of time, the bone can develop microfractures. Stress fractures present initially the same way as MTSS described above. As time passes this pain worsens and is eventually present during daily activities. The best way to diagnose a stress fracture is with a bone scan. Treatment of a stress fracture is with rest and anti-inflammatories but more severe cases may require casting or a walker boot. Females are much more prone to sustaining stress fracture than males.
The third condition which I want to tell you about that can cause shin pain is compartment syndrome. The lower leg is divided into 5 compartments which are separated by inelastic dividers called fascia. Muscles are contained in each of these compartments. During exercise if the pressure in any of these compartments increases beyond a certain level blood flow to the muscles is impeded and pain, cramping, burning or numbness can occur. Compartment syndrome is diagnosed by testing the pressures with a device that uses a needle inserted into each compartment immediately following exercise. Severe cases may require surgery.
The bottom line is don’t take shin pain for granted. Although it may not be stopping you exercising at present you could be heading for a much more serious problem down the tracks. The important thing is to get an accurate diagnosis initially to determine which condition is causing your “shin splints” and to treat it appropriately.
For further information contact the chartered physiotherapists at Sportsplus Physiotherapy and Rehabilitation Clinic, Quintin’s Way, Nenagh, 067-42837.