Shin pain (shin splints)

Shin pain (shin splints)

Shin pain (shin splints)

Shin pain is felt on or around the shin bone (tibia) and it may be localised or can spread up and down the inside or outside of the tibia.

'Shin splints' is an inexact term that encompasses a few specific conditions causing shin pain. These include medial tibial stress syndrome or tenoperiostitis, chronic exertional compartment syndrome and stress fracture.

Occasionally, referred pain from the knee, low back or sacro-iliac joints may result in pain in the shin region.

Symptoms

Medial tibial stress syndrome causes pain and tenderness along the inside of the lower leg. The pain is usually associated with running, and persists for a period of time after the activity ceases.

The pain may improve during the run, but recur towards the end or after the activity finishes. The same process can also occur on the outside edge of the tibia, which is why the problem is sometimes referred to as tenoperiostitis.

The area along the edge of the bone, where the muscle attaches to the tibia, will be tender.

Stress fracture usually causes localised pain situated at the junction of the upper and middle third of the tibia or the middle and lower third of the bone.

The pain in this situation is always with activity and the pain will become progressively worse during a run, and with successive runs. Pain will persist for hours to days afterwards.

The bone itself will be tender in this condition.

Compartment syndrome. Pain down the front of the muscular part of the leg, or deep in the calf, can be due to chronic exertional compartment syndrome.

Symptoms of compartment syndrome are leg pain, tightness or burning, with sensations such as tingling or pins and needles. The pain will build up during a run, to the point where the person has to stop.

On stopping exercise, the severe pain goes away within a few minutes, but a residual ache persists.

Causes

Medial tibial stress syndrome, stress fracture and compartment syndrome are all overuse injuries and the factors that cause them are similar.

In particular, both intrinsic factors (concerning the person exercising) and extrinsic factors (concerning the environment) can contribute.

They include such things as the person's training programme, footwear, the surfaces run or played on, and the person's biomechanics.

Medial tibial stress syndrome/tenoperiostitis. This results from repetitive stress on the tendon attachment to the bone.

It usually occurs along the inside of the bone, but can involve the outer surface either separately or with the inner surface.

The condition can be caused by overtraining, running on hard surfaces, with excessive cambers, poorly supportive footwear or can be associated with poor lower limb alignment such as excessive pronation (rolling in of the foot), knock knees or turned-in hips.

Chronic exertional compartment syndrome.

This occurs when the large muscle down the front of the shin (tibialis anterior), the deep calf muscles or occasionally the peroneal muscles on the outside of the leg, increase in size during activity with the normal increase in blood flow, but the skin or sheath around the muscle has become very tight.

This restricts the blood flow in and the muscle and hence as exercise progresses, the pain increases significantly due to lack of oxygen and build up of waste products. Contributing factors to this condition are training errors such as too rapid a build up in training, too much training, biomechanical malalignments and poor footwear.

Stress fractures of the tibia or fibula are overuse injuries that can occur in people who undertake a new exercise program and don’t build up the intensity gradually or experienced athletes that run excessive distances or undertake too many training sessions.

Stress fractures of the tibia are especially common in sports involving running and jumping.

They are most ly to occur in people who have poor biomechanics, who wear unsupportive footwear and/or run long distances on hard surfaces, or in female athletes who are undernourished, have menstrual irregularities and poor bone density.

Treatment

Medial tibial stress syndrome/tenoperiostitis: Relative rest, or avoiding the aggravating activity, ice and anti-inflammatory medicines are the mainstay of initial treatment, followed by rehabilitation exercises, such as calf stretching and muscle strengthening. Footwear must be assessed relative to the person's individual foot type. If the person has foot or gait abnormalities, orthotics may be recommended.

Chronic exertional compartment syndrome: The treatment of this condition can require up to 3 months of rest from the aggravating activity, footwear assessment and possible orthotic prescription. Stretching and strengthening exercises can be useful and deep therapeutic massage is sometimes recommended. Occasionally, surgery is needed to decompress the muscle compartments.

Stress fractures: Treatment usually involves rest from the aggravating activity, ice, and anti-inflammatory medicines. For runners, swimming or using an exercise bike may be appropriate activity while the fracture heals. A stress fracture may take between 4 and 12 weeks to heal, and occasionally longer, depending on the severity of the fracture itself.

References

1. The Merck Manuals Online Medical Library. The Merck Manual for Healthcare Professionals. Exercise and sports injury: Shin splints. Updated Oct 2014. Available from http://www.msdmanuals.com/en-au/professional/injuries;-poisoning/sports-injury/shin-splints (accessed Nov 2015).

Source: https://www.mydr.com.au/sports-fitness/shin-pain-shin-splints

Shin Splint Causes and Treatment

Shin pain (shin splints)

  • Shin splints are a type of “overuse injury” to the legs.
  • The pain is characteristic and located on the outer edge of the mid region of the leg next to the shinbone (tibia). It can be extreme and halt workouts.
  • The diagnosis requires a careful focused examination.
  • A multifaceted approach of “relative rest” can restore a pain-free level of activity and a return to competition.
  • The relative rest approach includes a change in the workout, ice, rest, anti-inflammatory medications, stretching exercises, possible change in footwear, and gradual increase in running activities.

What are shin splints?

Shin splints are injuries to the front of the outer leg. While the exact injury is not known, shin splints seem to result from inflammation due to injury of the soft tissues in the front of the outer leg.

Shin splints are a member of a group of injuries called overuse injuries. Shin splints occur most commonly in runners or aggressive walkers.

What are risk factors for shin splints?

Risk factors for shin splints include running and over-training on hills, inadequate footwear for athletic activity, and poor biomechanics of the design of the legs and feet.

What are shin splints symptoms?

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Shin splints cause pain in the front of the outer leg below the knee. The pain of shin splints is characteristically located on the outer edge of the mid region of the leg next to the shinbone (tibia). An area of discomfort measuring 4-6 inches (10-15 cm) in length is frequently present.

Pain is often noted at the early portion of the workout, then lessens, only to reappear near the end of the training session. Shin splint discomfort is often described as dull at first.

However, with continuing trauma, the pain can become so extreme as to cause the athlete to stop workouts altogether.

Sports injuries refer to the kinds of injury that occur during sports or exercise. While it is possible to injure any part of the body when playing sports, the term sports injuries is commonly used to refer to injuries of the musculoskeletal system.

Some of the most common sports injuries include:

  • Sprains: tears to the ligaments that join the ends of bones together. The ankles, knees, and wrists are commonly affected by sprains.
  • Strains: pulls or tears of muscles or tendons (the tissues that attach the muscles to the bones)
  • Shin splints“: pain along the outside front of the lower leg, commonly seen in runners
  • Achilles tendonitis or rupture of the Achilles tendon: These injuries involve the large band of tissue that connects the calf muscles to the heel.
  • Fractures of the bones
  • Dislocation of joints

Acute injuries usually occur suddenly while participating in sports or exercise.

They may result in sudden and severe pain, the inability to bear weight on a limb, or inability to move the affected part of the body.

Chronic injuries usually result from overuse of one area of the body over a period of time. Symptoms of chronic injuries include soreness, dull aching pain, and pain during participation in physical activity.

Find out about treating shin splints »

What causes shin splints?

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A primary culprit causing shin splints is a sudden increase in distance or intensity of a workout schedule.

This increase in muscle work can be associated with inflammation of the lower leg muscles, those muscles used in lifting the foot (the motion during which the foot pivots toward the tibia).

Such a situation can be aggravated by a tendency to pronate the foot (roll it excessively inward onto the arch).

Similarly, a tight Achilles tendon or weak ankle muscles are also often implicated in the development of shin splints.

How do health care professionals diagnose shin splints?

The diagnosis of shin splints is usually made during physical examination. It depends upon a careful review of the patient's history and a focused physical exam (on the examination of the shins and legs where local tenderness is noted).

Specialized (and costly) tests (for example, bone scans) are generally only necessary if the diagnosis is unclear. Radiology tests, such as X-rays, bone scan, or MRI scan, can be helpful in this setting to detect stress fracture of the tibia bone.

What is the treatment for shin splints?

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Previously, two different treatment management strategies were used: total rest or a “run through it” approach. The total rest was often an unacceptable option to the athlete. The run through it approach was even worse. It often led to worsening of the injury and of the symptoms.

Currently, a multifaceted approach of relative rest is successfully utilized to restore the athlete to a pain-free level of competition.

What is the multifaceted relative rest approach?

The following steps are part of the multifaceted approach:

  • Workouts such as stationary bicycling or pool running: These will allow maintenance of cardiovascular fitness.
  • Application of ice packs reduces inflammation.
  • Anti-inflammatory medications, such as ibuprofen (Advil/Motrin) or naproxen (Aleve/Naprosyn), are also a central part of rehabilitation.
  • A 4-inch wide Ace bandage wrapped around the region or a Neoprene calf sleeve also helps to reduce discomfort.
  • Calf and anterior (front of) leg stretching and strengthening address the biomechanical problems discussed above and reduce pain.
  • Pay careful attention to selecting the correct running shoe based upon the foot type (flexible pronator vs. rigid supinator). This is extremely important. In selected cases, shoe inserts (orthotics) may be necessary.
  • Stretching and strengthening exercises are done twice a day.
  • Run only when symptoms have generally resolved (often about two weeks) and with several restrictions:
    1. A level and soft terrain is best.
    2. Distance is limited to 50% of that tolerated preinjury.
    3. Intensity (pace) is similarly cut by one-half.
    4. Over a three- to six-week period, a gradual increase in distance is allowed.
    5. Only then can a gradual increase in pace be attempted.

Shin Splints See a medical illustration of the foot plus our entire medical gallery of human anatomy and physiology See Images

What is the prognosis (outlook) for shin splints?

The extent of injury that occurs prior to any rehabilitation program plays a significant role in determining the time frame necessary for complete recovery. Generally, the outlook is excellent for full recovery, but physical therapy treatment can be necessary.

Is it possible to prevent shin splints?

To the extent that shin splints are an overuse injury, shin splints can be prevented by gradually increasing exercise activities. Proper footwear can also help to prevent shin splints.

Medically Reviewed on 7/27/2018

References

Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.

Ruddy, Shaun, et al., eds. Kelley's Textbook of Rheumatology, 6th Ed. Philadelphia: Saunders, 2001.

Source: https://www.medicinenet.com/shin_splints/article.htm

Shin Splints Symptoms, Treatment, Recovery, and Prevention from WebMD

Shin pain (shin splints)

  • How Are They Treated?
  • 4 Signs Your Shin Splints Have Healed

Do your shins throb and ache after your daily run or just sprinting to catch the bus?

It could be shin splints. You might hear a doctor call it medial tibial stress syndrome. The cause is stress on your shinbone and the connective tissues that attach muscles to your bones. They get inflamed and painful.

This common problem can result from:

  • Flat feet — when the impact of a step makes your foot's arch collapse (your doctor will call this overpronation)
  • Shoes that don’t fit well or provide good support
  • Working out without warmup or cooldown stretches
  • Weak ankles, hips, or core muscles

If you’re active, you could get them if you make sudden changes more intense, more frequent, or longer workouts.

They often heal on their own. If you see a doctor, expect to get a thorough physical exam. She may want to watch you run to look for problems. She might also take X-rays or bone scans to look for fractures.

  • Rest your body. It needs time to heal.
  • Ice your shin to ease pain and swelling. Do it for 20-30 minutes every 3 to 4 hours for 2 to 3 days, or until the pain is gone.
  • Use insoles or orthotics for your shoes. Shoe inserts — which can be custom-made or bought off the shelf — may help if your arches collapse or flatten when you stand up.
  • Take anti-inflammatory painkillers, if you need them. Non-steroidal anti-inflammatory drugs (NSAIDs), ibuprofen, naproxen, or aspirin, will help with pain and swelling. These drugs can have side effects, though, a greater chance of bleeding and ulcers. Use them as directed on the label, unless your doctor says otherwise.

You’ll know they’re fully healed when:

  • Your injured leg is as flexible as your other leg.
  • Your injured leg feels as strong as your other leg.
  • You can push hard on spots that used to be painful.
  • You can jog, sprint, and jump without pain.

There's no way to say exactly when your shin splints will go away. It depends on what caused them. People also heal at different rates; 3 to 6 months isn’t unusual.

The most important thing is that you don’t rush back into your sport. If you start to work out before your shin heals, you may hurt yourself permanently.

Take up a new no-impact activity that won't aggravate your shin splints while they heal. If you’re a runner, try swimming or an aggressive interval bike program.

If your shin splints don’t get better, or if they come back, your doctor may suggest you see a physical therapist. He can treat issues in your legs or the way you move that could cause the problem. A therapist can also help ease the pain and guide your return to sport.

He’ll also make sure you don’t have a stress fracture — tiny cracks in your tibia.

SOURCES:

American Academy of Orthopaedic Surgeons: ''Shin Splints.''

Davis, M. Expert Guide to Sports Medicine, American College of Physicians Press, 2005.

Rouzier, P. The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.

Mayo Clinic: “Stress Fractures.”

© 2019 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/fitness-exercise/shin-splints

That Nagging Shin Pain…The Good, The Bad and The Ugly

Shin pain (shin splints)

Spring has sprung and the warmer temperatures make outdoor running a much more enjoyable form of exercise! Whether you are a novice runner or are deep into training for one of the area's upcoming races, many runners begin to experience the effects of increasing their mileage and begin suffering from Shin Splints or other related aches and pains at some point during their training.

We lump these injuries into a category of “overuse injuries” and in the shins specifically, injury can evolve into Stress Reactions and Stress Fractures if not treated properly.

Shin Splints is a term used by many to describe any type of pain experienced in the front or inside of the lower leg. You may also see Shin Splints referred to as Medial Tibial Stress Syndrome, or MTSS.

 Shin Splints occur as a result of inflammation to the muscles, tendons and periosteum of the tibia, the larger of the two lower leg bones. Symptoms include pain and tenderness along the inside or front of the tibia.

Shin Splints can be diagnosed through a physical exam with a Sports Medicine Provider and are initially managed conservatively, without impacting an athlete’s training goals.

Risk Factors for Shin Splints:

  • Repetitive pounding on a hard surfaces (too much concrete/asphalt)
  • Improper footwear (bad shoes) 
  • High or low arches (blame the factory)
  • Too much mileage, too soon  (don’t push it)
  • Continued running when fatigued (listen to your body)
  • Poor flexibility (utilize Orthopedic ONE Therapy Services’ Dynamic Warm-Up and Static Cool Down Warm-Up and Static Cool Down video)
  • Decreased stability and strength in the core, hips and legs (try Orthopedic ONE Therapy Services’ Core Strength Exercises and Gluteal Muscle Exercises videos )
  • Unhealthy bone such as osteopenia and osteoporosis (talk to your Sports Medicine Provider) 

This chart illustrates of how a typical Shin Splint can progress into something more if you don’t listen to your body!

Stress Reaction: Stress Reactions are overuse injuries, caused by repeated or excessive stress on the bone. Runners experiencing this ailment report aching in the bone or soreness at rest and when running when a stress reaction is present.

These injuries are more challenging to diagnose with a physical exam and may require imaging tests, such as an X-ray, MRI or bone scan.

An imaging test that is positive for a Stress Reaction will show increased bone metabolism in the area of the injury and may even show “microscopic fractures” along with changes in the bone.

  These changes are reversible and your Sports Medicine Team can create a rehab program that will allow you to resume running after a short break. If left untreated, a Stress Reaction can be a precursor to a Stress Fracture. 

Stress Fracture: A Stress Fracture is the outcome of unmanaged Shin Splints. With each stride you take while running, you are loading your body weight into the ground and the ground is pushing back up through your body with an equal amount of force.

With proper mechanics your joints and muscles help absorb this shock, ensuring that too much stress is not put on the shaft of the bone.

However, when your muscles are fatigued or if you have poor mechanics, this causes an extreme amount of stress, leading to a weakening of the bone and the potential for a Stress Fracture.

Radiographic Changes:  If you begin experiencing shin pain and seek treatment, oftentimes your Sports Medicine Provider will recommend getting an X-ray so they can fully understand the scope of your condition.

When the results of your X-ray show changes to the bone, there is good news and bad news. The good news is that the damage cause by the Stress Fracture is reversible. The bad news is that this will put a halt to your current training plan.

There are several different Radiographic Changes that are indicative of a Stress Fracture.

  • Periosteal Bone Formation is the creation of new bone on the fibrous tissue that covers the bone shaft. 
  • A horizontal or angular line of Sclerosis, (a hardening of tissue) on the bone is another sign of fracture. 
  • Endosteal Callus Formation occurs when a callus forms on the endosteum, the connective tissue that lines the bone marrow cavity inside the bone. 
  • Finally, and probably the most obvious of radiographic changes, is a visible fracture line.  

If you are experiencing pain in your shins that is limiting your training, Orthopedic ONE can help! Our team of physicians, therapists and trainers provide orthopedic, injury prevention and rehabilitation services to some of the most elite professional organizations in central Ohio, as well as collegiate, high school and club programs. Our goal is to keep athletes our office and back to doing the activities they love.  

Source: https://www.orthopedicone.com/news-events/that-nagging-shin-pain-the-good-the-bad-and-the-ugly

Everything You Should Know About Shin Splints

Shin pain (shin splints)

Shin splints (called medial tibial stress syndrome) is a common condition among athletes that causes sharp or dull pain over the front of the shin bone (called the tibia) that often limits a person's ability to walk or run. 

The diagnosis of shin splints is made through a medical history and physical examination. Imaging tests may be ordered to confirm the diagnosis or rule out alternative diagnoses a stress fracture of the shin bone.

Treatment is conservative and involves rest followed by activity modification. Ice, taking an anti-inflammatory medication, and physical therapy may also be helpful.

Verywell / Jessica Olah

At the root of shin splints are microfractures (tiny breaks in the shin bone) and inflammation of the tissue that surrounds the shin bone. These tiny breaks and inflammation occur as a result of the leg being overworked by repetitive activity.

Classic repetitive activities that trigger shin splints include running, dancing, and military training.

The primary symptom of shin splints is pain along the border of the tibia bone (often described as sharp, dull, or throbbing). This pain is usually felt during and after physical activity. Mild swelling may also be present, and the shin is often sore to touch. 

If you have shin pain, your doctor will perform a medical history and physical exam. In some instances, your doctor may order one or more diagnostic tests.

In addition to reviewing your symptoms, especially the specifics regarding your pain (e.g., location, intensity, and what makes it better or worse), a physical examination that focuses on muscle palpation, range of motion, and strength can help your doctor make a diagnosis of shin splints.

  • X-ray: An x-ray may be done to rule out a fracture in your shin bone.
  • Electromyographical (EMG) testing: An EMG may be done to check on how your leg's nerves are functioning.
  • Magnetic resonance imaging (MRI): An MRI shows pictures of the soft tissue around your lower extremities and can show which muscles may be injured and causing your pain.
  • Ultrasound: An ultrasound can check your lower leg for blood clots which may be causing your pain.

The treatment of shin splints involves rest (often several weeks of taking a break from the inciting activity that caused the pain), as well as these basic therapies:

  • Ice the Area: Apply ice over your shin several times a day for no more than 15 to 20 minutes at a time
  • Take an anti-inflammatory medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can soothe pain and reduce swelling and inflammation (be sure to only take an NSAID under the guidance of your doctor)
  • Wear supportive shoes: Shoes with proper cushioning can ease stress in your shins; some people may even benefit from orthotics

Physical therapy may also be part of your treatment plan for shin splints.

The goals of physical therapy are to manage the inflammatory process in your anterior tibialis muscle in the front of your shin and to work to change the biomechanical faults that may be causing your shin splints. 

These goals can be accomplished through many different strategies, including:

While there is no definitive answer to this question, generally speaking, you can expect to deal with your shin splints for about two months. Recovery may be longer if you do not adequately rest, or shorter, if your shin splints are mild and respond promptly to treatment.

There are several things you can do to prevent shin splints, such as:

  • Wear a supportive, cushioned shoe that fits your foot properly (whether you have a flat foot or a high-arch)
  • Alternative your activity—so instead of running every day, for instance, switch it up with swimming or cycling
  • Do not overdo it—increase your running or other exercise regimens slowly and gradually (if you experience pain, stop the activity)

If you develop pain in the front part of your lower leg that occurs with walking or running, you may have shin splints. However, there may be other causes of lower leg pain, so be sure to see your doctor.

Once a proper diagnosis is made for your condition, the correct treatment can be started and you can be on the road to a speedy recovery and future prevention.

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Source: https://www.verywellhealth.com/is-your-shin-pain-really-shin-splints-2696551

Shin Splints

Shin pain (shin splints)

Shin splints is a common complaint, especially among participants of running sports. The term 'shin splints' is colloquially used to describe shin pain along the inside or front edges of the shin. Shin splints are the most common cause of painful shins. 

There are two regions where you can suffer shin splints: 

  1. Anterior Shin Splints
  2. Posterior Shin Splints

Anterior Shin Splints

Anterior shin splints are located on the front (or anterior) part of the shin bone and involve the tibialis anterior muscle. The tibialis anterior lifts and lowers your foot. It lifts your foot during the swing phase of a stride. Then, it slowly lowers your foot to prepare your foot for the support phase.

If your anterior shin pain increases when lifting your toes up while keeping heels on the ground – you are ly to suffer from anterior shin splints. Medically anterior shin splints can also be referred to as anterior tibial stress syndrome (ATSS).

Posterior Shin Splints

Posterior shin splints are located on the inside rear (or medial/posterior) part of the shin bone and involve the tibialis posterior muscle.

The tibialis posterior lifts and controls the medial aspect of your foot arch during the weight bearing support phase.

When your tibialis posterior is weak or lacks endurance your arch collapses (overpronation), which creates torsional shin bone stresses.

If you feel pain along the inside rear of your shin bone – you are ly to suffer from either posterior shin splints or tibia stress fractures. Medically, posterior shin splints and tibial stress fractures can also be referred to as medial tibial stress syndrome (MTSS).

What Causes Shin Splints?

Shin splints are caused by overstraining of your muscles where they attach to your shin.

The most common cause is overuse or overtraining associated with poor foot and leg biomechanics. Shin splints can be caused by a number of factors which are mainly biomechanical (abnormal movement patterns) and errors in training.

Some of the most common causes of shin splints include:

Overtraining / Overloading:

  • Increasing your training too quickly
  • Running on hard or angled surfaces
  • Insufficient rest between loads

Biomechanical:

  • Overpronation of your feet
  • Oversupination of your feet
  • Decreased flexibility at your ankle joint
  • Poor hip-knee-leg muscle control (dynamic alignment)
  • Poor buttock control at in the stance phase
  • Poor core stability
  • Tight calf muscles, hamstrings
  • Weak quadriceps, foot arch muscles

Equipment:

Generally shin pain arises from a combination of three structures:

  • Muscles
  • Tenoperiosteum
  • Shin bone (tibia)

Muscle

As a result of repeated overuse, one or more of your muscles in the lower leg may become injured through excessive loading stress. This can result in muscle tenderness, inflammation or knots.

The most common muscles that cause shin splints are tibialis anterior (anterior shin splints) and tibialis posterior (posterior shin splints).

Tenoperiosteum

All bones are covered in a 'shell', called periosteum. The tendons, which connect the muscle to the bone, attach on to this periosteum. This zone at which the tendon meets the bone is known as tenoperiosteum.

Almost all cases of 'shin splints' have some element of inflammation of the tenoperiosteum. Inflammation of different tendons leads to pain in different areas of the shin.

Bone

Damage to the shin bone usually concentrates in the lower one-third of the shin bone (tibia). The bone damage may be mild, such as a simple stress reaction, or may be a severe stress fracture. Except in the worst cases, bone damage is not visible on normal x-rays. A bone scan or MRI may be recommended if your physiotherapist or doctor need to exclude or confirm a bone injury.

What are the Symptoms of Shin Splints?

  • Shin splints cause dull, aching pain in the front of the lower leg. 
  • Depending on the exact cause, the pain may be located along either side of the shinbone or in the muscles. 
  • The area may be painful to the touch.

The Four Stages of an Overuse Injury:

Your physiotherapist will guide you with respect to how much exercise you can do. Here are some basic guidelines until you seek your physiotherapist's opinion:

Stage 1

  • Discomfort that disappears during warm-up.

Injury identification and treatment in stage one allows continuing activity as long as the injury does not worsen. Professional guidance is recommended to confirm your diagnosis and to implement treatment strategies to ensure that your condition does not deteriorate.

Stage 2

  • Discomfort that may disappear during warm-up but reappears at the end of activity. 

At stage two, the activity may continue at a modified pain-free level while being treated. Professional assessment and treatment is highly recommended and must continue until you have completely resumed normal activity and training levels. 

Stage 3

  • Discomfort that gets worse during the activity.

If the injury progresses to stage three, the activity must immediately cease.

 Professional guidance is very highly recommended to confirm diagnosis and ensure that the condition has not progressed into bone stress fractures.

A thorough rehabilitation program is recommended to gradually return to your desired activity and exercise levels.

Stage 4

  • Pain or discomfort all the time.

All activity must immediately cease. Professional guidance is essential to exclude stress fractures or more significant tibia fractures.

Potentially, you may need to be non-weight bear on crutches or in an air cast.

Please book an appointment with your healthcare professional who has a special interest in shin pain to fully investigate and rehabilitate you their assessment.

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How is Shin Splints Diagnosed?

Shin splints are usually diagnosed your medical history and a physical examination by your physiotherapist. In some cases, an X-ray or other imaging studies such as bone scans or MRI can help identify other possible causes for your pain, such as a stress fracture.

Phase 1 – Early Injury Protection: Pain Reduction & Anti-inflammatory Phase

As with most soft tissue injuries the initial treatment is – Rest, Ice and Protection.

In the early phase you may be unable to walk or run without pain, so your shin muscles and bones need some active rest from weight-bearing loads.

Your physiotherapist will advise you on what they feel is best for you. Ice is a simple and effective modality to reduce your pain and swelling.

Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot. 

Anti-inflammatory medication (if tolerated) and natural substances eg arnica may help reduce your pain and swelling.

However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain reducing medication.

As you improve a kinesio style supportive taping will help to support the injured soft tissue and provide some stress reduction for your shin bone.

Phase 2: Regain Full Range of Motion

If you protect your injured shin muscles while they heal and strengthen. This may take several weeks.

During this time period, you should be aiming to optimally remould your scar tissue to prevent a poorly formed scar that will re-tear in the future.

It is important to lengthen and orientate your healing scar tissue via massage, muscle stretches, neurodynamic mobilisations and specific exercises. Your physiotherapist will guide you.

Phase 3: Normalise Foot Biomechanics

Shin splints commonly occur from poor foot biomechanics eg flat foot. In order to prevent a recurrence, your foot will be assessed. In some instances, you may require a foot orthotic (shoe insert) or you may be a candidate for the Active Foot Posture Stabilisation program.

Your physiotherapist will happily discuss the pros and cons of both options to you.

Phase 4: Restore Muscle Strength

Your calf, shin, quadriceps, gluteal and other lower limb muscles may need strengthening to enable a safe resumption of sport or training.

Phase 5: Modified Training Program & Return to Sport

Most shin splints occur due to excessive training loads. Running sports place enormous forces on your body (contractile and non-contractile). 

In order to prevent a recurrence as you return to your sport, your physiotherapist will guide you with training schedules and exercises to address these important components of rehabilitation to both prevent a recurrence and improve your sporting performance. 

Depending on the demands of your chosen sport, you will require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to your chosen sport.

Your PhysioWorks physiotherapist will discuss your goals, time frames and training schedules with you to optimise you for a complete return to sport. The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a through rehabilitation program has minimised your chance of future injury.

What Results Should You Expect?

There is no specific time frame for when to progress from each stage to the next. Your shin splints rehabilitation status will be determined by many factors during your physiotherapist's clinical assessment.

You'll find that in most cases, your physiotherapist will seamlessly progress between the rehabilitation phases as your clinical assessment and function improves.

It is also important to note that each progression must be carefully monitored as attempting to progress too soon to the next level can lead to re-injury and frustration.

The severity of your shin splints, your compliance with treatment and the workload that you need to return to will ultimately determine how long your injury takes to successfully rehabilitate.

Are Shin Splints Serious?

Left untreated and with continued overtraining, shin splints can progress into tibial stress fractures, which will require a minimum of six weeks resting on the couch.

Less commonly, if your muscle sheaths become compressed by engorged muscles – muscle compartment syndrome can develop.

Muscle compartment syndrome is a very serious shin complaint that often requires surgical intervention to prevent permanent muscle damage.

For more information please contact your physiotherapist.

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Common Treatments for Shin Splints

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • What to do after a Muscle Strain or Ligament Sprain?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Scapular Stabilisation Exercises
  • Active Foot Posture Correction Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Agility & Sport-Specific Exercises
  • Medications?
  • Real Time Ultrasound Physiotherapy
  • Soft Tissue Massage
  • Walking Boot
  • Brace or Support
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Kinesiology Tape
  • Neurodynamics
  • Prehabilitation
  • Running Analysis
  • Strength Exercises
  • Stretching Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Shin Pain

    • Shin Splints
    • Stress Fracture
    • Tibialis Posterior Tendinopathy

    Systemic Conditions

    • Rheumatoid Arthritis
    • Fibromyalgia
    • Psoriatic Arthritis
    • Lupus

    FAQs about Shin Splints

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Massage Styles and their Benefits
  • What Causes Post-Exercise Muscular Pain?
  • Barefoot Running: Your MUST READ Guide to the Pro's and Con's.
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs.

    Why Does Heat Feel So Good?

  • How Can You Prevent a Future Leg Injury?
  • How Much Treatment Will You Need?
  • Post-Run Soreness: Should You Be Concerned?
  • Runners: How to Reduce Your Knee Stress
  • What are Growing Pains?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
  • Call PhysioWorks

    Book Online

    Source: https://physioworks.com.au/injuries-conditions-1/shin-splints

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