1. What are “shin splints”?
Shin splints are overuse injuries that occur in the lower leg. They may be due to a tearing of the muscle/tendon junction or inflammation where the muscle attaches to the bone (periostitis). Shin splints are now more commonly called medial tibial stress syndrome (MTSS) when they involve the inner aspect of the lower leg.
2. What are the causes/predisposing factors of injury?
Any type of abnormal foot biomechanics can predispose to shin splints. The most common biomechanical problem is overpronation. Biomechanical misalignment of the hips or legs can also lead to shin splints, along with improper footwear, and training errors such as excessive hill running or too much mileage without the proper build up.
3. What are the symptoms?
A dull ache in the shin that increases in intensity as you work out and subsides later is the general symptom. The shin may be exquisitely tender to touch, and can be mildly swollen and bumpy. In the worst case scenario, this injury can progress to a tibial stress fracture which is painful at all times.
4. What can be done to prevent or treat this condition?
Prevention has multiple components. Correction of biomechanical problems with proper shoes and semi-flexible orthotics (if required) is recommended. Strengthening and increasing the flexibility of the shin and calve muscles is also important. As well, try to avoid running on hard surfaces every day, and do not increase mileage or hill running unreasonably.
Treatment initially focuses on reducing inflammation. Ice the area of complaint for 15 minutes after the workout, and continue to ice for at least 2-4 more times per day for 15 minutes each session. I like using Styrofoam cups that are filled with water, and then frozen. Peel away the Styrofoam at the top of the cup and you have a nice way of doing an ice massage of the area. Aspirin or ibuprofen can also be taken to reduce inflammation. Cross training with a lower impact cardio activity or reducing mileage is also appropriate. Physical therapy modalities and cross friction massage are also helpful, as well as soft tissue work on the involved muscle groups. Again, a semi-flexible foot orthotic, if needed, should be used.