What Is Shin Splints?
Shin splints is pain on the front of the lower leg below the knee and above the ankle. It can hurt over the shin-bone (tibia) or over the muscles on either side of the shinbone. Shin splints is also called shin pain.
How Does It Occur?
Shin pain generally occurs from overuse. This problem can come from stress fractures of the tibia or fibula (the other bone in the lower leg) or from irritation of the muscles or other tissues in the lower leg.
The muscles in your leg are grouped within compartments. Inflamed muscles can cause swelling in the leg compartments. This is called compartment syndrome. The anterior compartment is the one must commonly affected in shin pain.
Shin pain can occur in runners who increase their mileage or the intensity of their running, or who change the surface on which they are running. When you walk or run, your foot normally flattens out a small amount when it strikes the ground. If your foot flattens out more than normal, it is called over-pronation. Over-pronation can contribute to shin pain.
What Are The Symptoms?
You have pain over the front part of your lower leg. You may have pain at rest, during exercise, or both.
How Is It Diagnosed?
Your doctor will examine your lower leg. He or she will look for tenderness over the front of your shin. Your doctor may watch you walk or run to see if you have problems with over-pronation. Your doctor may order x-rays or a bone scan to check for stress fractures. If your doctor thinks you have a severe case of compartment syndrome, he or she may order a test that measures pressure within the leg compartments.
How Is It Treated?
Treatment may include:
When Can I Return To My Sport Or Activity?
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your leg recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.
You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
How Can I Prevent Shin Pain?
Written by Pierre Rouzier, M.D., for Clinical Reference Systems.
Shin Splints Rehabilitation Exercises
Start these exercises when your pain has decreased by about 25% from the time when your injury was most painful.
Calf stretch with towel: Sitting on a firm surface with your
injured leg straight in front of you, take a towel and loop it
around the ball of your foot. Pull the towel toward you. Hold this
position for 30 seconds. Relax. Repeat 3 times. When you don't
feel much of a stretch anymore using the towel, start stretching
the calf in the standing position described below.
Standing calf stretch: Facing a wall, place both hands at about
eye level on the wall. Keep your uninjured leg forward and your
injured leg back about 12 to 18 inches behind your uninjured leg.
Keep your injured leg straight and your heel on the floor. Next,
do a slight lunge by bending the knee of the forward leg. Lean
into the wall until you feel a stretch in your calf muscle. Hold this
for 30 to 60 seconds. Repeat 3 times.
Resisted dorsiflexion flexion: Sit in front of a doorway with your
legs outstretched. Anchor the Thera-Band in a door by tying
knots in the ends and closing the knots in the door. Next, loop
the Thera-Band around the forefoot of your injured leg. Pull
your foot toward your face with the Thera-Band supplying
resistance. Return slowly to the starting position. Repeat 10
times. Do 3 sets of 10.
Resisted plantar flexion: Sitting with your legs outstretched, put
the tubing around the foot of your injured leg and hold the ends
of the tubing in your hands. Gently press your foot down
stretching the Thera-Band. Return to the starting position.
Repeat 10 times. Do 3 sets of 10.
Resisted inversion: Sit on the floor with your uninjured leg
crossed over your injured ankle. Hold one end of the Thera-Band
in your hand and tie the other end in a loop. Place the loop
around the forefoot of the injured leg and have the band
wrapped around the uninjured foot to provide an anchor. Move
your injured foot inward with the Thera-Band providing
resistance. Return your foot to the starting position. Repeat 10
times. Do 3 sets of 10.
Resisted eversion: Sitting on the floor with both legs straight
out, have the Thera-Band looped around both feet. Slowly turn
the injured foot outward, keeping the uninjured foot still. Return
to the starting position. Repeat 10 times. Do 3 sets of 10.
Sitting: Sit on a firm surface with your feet flat on the floor. Keep
your heel on the floor and raise your toes off the floor. Repeat 10
times. Do 3 sets of 10. When the sitting exercise becomes easy,
progress to standing, as described below.
Standing: Standing with your feet flat on the floor, rock back
onto your heels and lift your toes off the floor. Hold this for 5
seconds. Repeat 10 times. Do 3 sets of 10.
Written by Tammy White,M.S., P.T., for Clinical Reference Systems
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