Typically, with shin splints, a person will be doing some kind of athletic endeavor (walking a long distance would qualify), and begin to notice soreness in the lower leg, either in the front or back of the leg. The more the person moves the more the condition worsen. Should the person stop, the pain will diminish somewhat only to worsen once the activity is resumed.
Anterior shin splints, or pain in the front of the lower leg, may be more prevalent running on hard surfaces, or running or walking down hill. After the heel hits the ground, in gait, the foot should slow down in order for the front of the foot to hit the ground. People with a tight heel cord (Achilles tendon), do not allow the foot to slow down so the muscles that control the forefoot and originate in the front of the lower leg are forced to overwork. This overworking of the muscle causes the muscle to swell and since the muscle is in a confined location in the lower leg, the swelling causes pain.
Posterior shin splints generally occur when in people who are moderately to severely pronated or more commonly known as flat footed. People who exhibit this type of foot structure force their feet to overwork, thus causing the muscles in the back of the lower leg to also overwork. Again, this overworking causes the muscle to swell and since it too is in a confined space, pain will occur.
As previously stated this condition generally occurs in athletic people, but people exhibiting certain types of foot structure, who are called upon to do a fair amount of walking can also experience shin splints.
Symptomatic treatment of the condition is through the use of icing the area and taking anti inflammatory medication such as aspirin, Aleve, Motrin, Advil, etc. Also, avoiding the type of walking surface that caused the problem would be indicated. This is acceptable treatment for the short term, but not considered a solution to the problem.
The best way to alleviate the problem on a permanent basis is to have your feet examined by a foot specialist to determine the type of foot structure you exhibit and thus find the cause of the problem. Generally, an orthotic, usually a prescription type of device will be indicated, but certain individuals may also experience relief with an over the counter type device. In addition to an orthotic, the athletic individual should also examine his athletic shoes as there are various types of shoes on the market, many of which may help correct the abnormality in the foot structure and thus relieve the symptoms.
The non-athlete should also examine his or her shoes as flimsy type shoes may exacerbate the abnormality in that person's foot structure and bring about the pain associated with shin splints.
Other conditions that may mimic shin splints include stress fractures of the lower leg, along with muscle tears. Anyone who is suffering from shin splints that do not respond to the above mentioned treatments should consider having an MRI to rule out theses possibilities.
Lastly, a condition that mimics shin splints but has the potential for more serious consequences is known as "anterior compartment syndrome". It is basically a more severe form of anterior shin splints, however, in this case the excessive swelling of the muscle will cause excessive pressure on the nerves resulting in numbness in the area and weakening of the muscles into the foot. Equally important, the blood supply in the affected area is cut off. The patient will complain of numbness in the foot and leg, along with pallor (due to the circulation being cut off), along with excessive pain. This is considered a medical emergency and immediate medical care is indicated.
What Are Shin Splints
When shin pain occurs during running, the condition is commonly referred to as Shin Splints. However, sports medicine professionals refrain from using the term since it can be misleading. People often assume that shin pain and ?Shin Splint? are synonymous terms. However, both may actually be mere indicators of a variety of other conditions. Medial Tibial Stress Syndrome is one of the prevalent skin conditions which have been referred to as ?Shin Splints?.
Gymnasts, Soccer players, dancers, distance runners and military recruits have all been reported to have a high occurrence of Medial Tibial Stress Syndrome. This syndrome is classified according to which shin tissue it affects:
Type one
- This occurs when there is the inside border of the shin bone creates a stress reaction. This stress reaction usually signals a stress fracture.
Type Two
- This type happens when an irritation persists on the point in the shin bone where the Soleus and Tibialis Posterior Muscles are attached.
Commonly caused by overuse, The Medial Tibial Stress Syndrome typically affects people who regularly run on hard and/or uneven surfaces. However, the risk of developing the syndrome may be increased by a range of other factors such as the altered posture of the foot, knee and hip.
Shin Splints Signs & Symptoms
For those afflicted with the Medial Tibial Syndrome, the duration as well as the end of a workout will produce a feeling of pain coming from the inner border of the shin. However, a proper diagnosis of Medial Stress Syndrome may only be made once Compartment Syndrome, Tibial Stress Fracture and other sources of shin pain are effectively ruled out. Confirming the diagnosis will entail a complicated process of investigations. With the supervision of a sports physician or orthopaedic doctor, bone scans and compartment pressure tests may be utilized.
Shin Splints Treatment
What you can do
Ice therapy is an ideal way to give immediate pain relief to the injured person. Applying ice packs directly to the skin may cause ice burns so extra care is needed when implementing this form of treatment. Moreover, pain will be effectively alleviated if the initial treatment of this injury is guided by the PRICE protocol: protection, rest, ice, compression and elevation. As for the ice packs, they must be applied every few hours, for twenty minutes each time. If the pain continues to persist, pain-relieving medicines and anti-inflammatory gels may be used.
In many patients, symptoms are easily treated without surgery. With rest, the patients will also engage on exercises designed to improve their flexibility and strength. Gradually, the symptoms will subside and the patient will be able to return to activities like running. A physiotherapist or podiatrist may also perform a bio-mechanical analysis, a procedure that examines the posture of the shin during rest and while walking as well as running. This analysis will help prevent the recurrence of the injury since it can reveal the factors that may be increasing the patient's risk to Medial Tibial Stress Syndrome. As a result, measures may immediately be implemented to correct the detected injuries.
A physiotherapy analysis may also detect the presence of muscle imbalance, leg length inequality as well as other causes of mal-alignment.
Medial Tibial Stress Syndrome is also usually caused by other conditions such as that of pes planus or flat-footedness. Another common cause is the pronated foot position, a condition in which running causes the arch of the foot to be lowered involuntarily. This produces pain since the lowered arch increases strain on the Tibialis posterior muscle which in turn pulls on the inside of the shin. This condition and many others can effectively be diagnosed through a bio-mechanical analysis.
Continuing with exercise or any physical activity may worsen any existing shin condition so it is advisable to get a chartered physiotherapist or orthopaedic consultant to assess the shin pain immediately. However, if the patient wants to maintain fitness during treatment of the injury, non-weight bearing exercises in the pool may be ideal. In order to have a low-impact workout while allowing the injury to heal, the patient may opt to use a buoyancy belt in order to do some running exercises in the pool. The buoyancy belt will keep the patient's feet from touching the floor of the pool, effectively eliminating any possible strain on the injured leg.
In the instance that a doctor finds that the shin pain is actually a soft tissue problem, the patient may uses a compression sleeve. The sleeve will allow them to run while continuing with the treatment of the injury. While running, the sleeve will limit the pull of the muscles on the shin, thus reducing stress. Although compression sleeves do not present s cure, they can reduce symptoms while allowing the runners to engage in some level of physical activity.
If the Medial Tibial Stress Syndrome does not respond to conservative treatment, surgery may be considered.
Shin Splints Prevention
What you can do
Typical of injuries involving overuse, Medial Tibial Stress Syndrome results from untimely participation in excessive physical activity. Physical activity must always increase gradually especially when starting or altering a fitness regimen. For instance, when a runner suddenly decides to run for 10 miles today even though his usual routine calls for only 2 miles of running, he inevitably puts his body at risk. Such a danger can be prevented through the maintenance of a running log.
The use of running shoes with Shock Absorbing Insoles will provide better support and help reduce the stress placed on the shins. Correction of activities like flat feet and fallen arches may also prevent the development of Medial Tibial Stress Syndrome. If fallen arches seem to contribute to shin pain, the Aircast AirLift may be used to provide better support. The Aircast AirLift utilizes aircells which lift the arch of the foot, this results in considerably less pressure on the arch and on the Tibialis Posterior Tendon.
Both Dr. Marc Mitnick & Steven Hayes are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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