Many young athletes suffer from “shin splints,” which means pain in the large bone in the front of your lower leg (the tibia). Shin splints are also referred to as medial tibial stress syndrome. The condition is frequently seen in athletes who have changed or intensified their exercise routines because the increased activity strains the muscles, tendons, and bone tissue.
Your lower leg muscles are divided into four compartments. These compartments are separated by a layer of fascia, a fibrous sheet that holds the muscles, nerves, and blood vessels together. Of these, the posterior compartment of the leg consists of a deep part and a superficial part. The deep part is behind the tibia and contains the muscles that control downward flexion and foot inversion. The superficial part contains the calf muscles, which work together to lift the heel off of the ground. Chronic exertional compartment syndrome, therefore, is a painful condition brought on by exercise. Anyone can develop this condition, but it is most common in athletes.
Who is at risk?
Shin splints often happen to people who engage in exercise or sports that put a great deal of stress on their legs and feet. The repeated impact keeps your body from restoring itself. Studies show that shin splints account for approximately 10.7 percent of injuries in male runners, but 16.8 percent of injuries in female runners. In general, young athletes tend to develop the condition as a result of being overactive or increasing the length, intensity, or surface conditions of the workout. If untreated, shin splint pain may interfere with the practice of the sport.
Although you may be more likely to develop shin splints from sports such as basketball, soccer, or tennis, it may affect anyone who engages in moderate to heavy physical activity. Other risk factors include a high Body Mass Index (BMI). If you have a higher than normal BMI, you may experience shin splints. Any type of physical activity, from heavy lifting to housework, which causes your muscles, bones, and tendons to be strained can lead to shin splints, especially if you have recently increased your activity.
The symptoms of shin splints usually include a gradual pain on the inside of the shin bone or tibia, as well as leg cramps or leg tightness. Your doctor will complete a physical exam and medical history. In some cases, the doctor may also order an X-ray or other imaging studies to identify possible stress fractures or other problems.
In some cases, shin splints can be treated with simple self-care measures, such as rest, switching to low-impact exercise, ice packs, or over-the-counter pain relievers.
Shin splints can, however, be stubborn and difficult to treat. Physical therapy is often very effective in treating the pain of shin splints. In addition to rest and ice, your physical therapist may recommend taping the affected area or massaging the injured tissue.
Your physical therapist may also prescribe exercises to strengthen the affected muscles. These exercises may include:
- Changes in your gait and foot control when running and walking
- Changes in techniques for athletes who must jump
- Exercises to decrease the inward rolling of the arch of the foot and increase the arch and shin muscle strength
- Exercises to reduce stress on the lower leg such as increasing hip rotation, lifting your leg behind your body, and lifting the leg away from the other leg
- Stretching exercises for the calf and foot muscles
- Single-leg exercises including squats, reaching exercises, or heel raises
- Different footwear for walking or exercising, possibly with orthotic support to keep your feet from becoming too flat
While shin splints may be common and frustrating, they should be taken seriously. An injury such as shin splints can cause swelling and damage to the fibrous tissue, muscles, and nerves. Compartment syndrome may result in a serious infection. A shin splint may also have progressed and become a stress fracture.
To help prevent the pain of shin splints or a serious problem, physical therapists recommend that you:
- Do appropriate stretches before and after exercise
- Regularly do exercises for the muscles of your legs, feet, hips, and pelvis
- Maintain a recommended and careful training program
- Have an annual functional fitness examination.
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