Doctor, my shins are killing me!

May 15, 2010 Posted by Dr.Murray
“Shin Splints” is a common term for any exercise-related leg pain. The most common cause of exercise related leg pain is Medial Tibial Stress Syndrome (MTSS). Other frequent causes of exercise related leg pain in athletes are stress fracture or posterior compartment syndrome.
MTSS, a specific overuse injury, causes pain along the posterior inside & outside aspects of the lower leg. Athletes most commonly afflicted with this condition compete in track, cross-country, basketball, and volleyball. The incidence of MTSS in long-distance runners is reported as high as 16.8%. It affects females more than males. In our experiences it occurs frequently from training error and running on uneven surfaces.
There is no consensus on the cause. Some believe it is inflammation of deep fascia or strain of deep muscles of the leg. Others believe it is tearing of the leg bone-muscle interface. Yet, another theory is a stress reaction of the bone that has become painful.
The diagnosis is made by history, clinical exam and full consideration of the symptoms. Commonly, athletes will complain of pain at the beginning of a run that seems to subside during the middle but recurs at the end of the run. Some risk factors for MTSS are: excessive foot pronation (flat feet), tight calf muscles, foot/leg geometry and alignment, body mass, sex and age. Diagnostic exams can be utilized if other conditions are suspected and initial treatment program does not result in improvement.
As for most overuse injuries treatment involves cessation of the activity. Assumption of alternative forms of exercise should be utilized if competitive athletes want to remain in condition. Stabilization of the foot is essential if excessive pronation is found. Support of the foot will involve evaluation of shoes for wear. Replace if necessary. Foot orthotics should also be considered and made to specifications based of appropriate biomechanical foot exam and gait analysis. Anti-inflammatory medications are also helpful for pain control. Finally, a well directed range of motion, stretching and muscle recovery-rehabilitation-strengthening program should be started (see articles below).
If you suffer from shin splints or know someone who does make and appointment at Blue Ridge Foot and Ankle Clinic. We can help keep you “in the game.”
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