The term shin splints refers to a group of problems causing pain in the shinbone (tibia), the big bone in the front of the lower leg. These problems include medial tibial stress syndrome (the most common cause of shin splints), stress fractures, and flat or high-arched feet. Dancers and athletes such as runners or power walkers can have this common exercise-related pain. People who play soccer, jog, or train for a race are at risk of having shin splints. The two types are anterolateral (front, outside) and posteromedial (back, inside).
Pain is caused by inflammation (irritated tissue) from injury to muscles, tendons, and the outside of bones. Causes include overuse, tight Achilles tendon, weak ankle muscles, flat arches, high arches, and sudden increase in intensity, frequency, or duration of activity. Running downhill or on slanted surfaces, playing sports with frequent starts and stops (basketball, tennis), training too hard or too long, and wearing worn-out shoes can also cause it.
Symptoms are dull, aching pain along the shinbone or in lower leg muscles. Pushing the foot down against resistance can cause the pain. Tenderness, soreness, or mild swelling can occur.
The health care provider makes a diagnosis from the medical history and physical examination. Imaging studies, such as x-rays, bone scans, or magnetic resonance imaging (MRI), may help find other problems such as broken bones (stress fractures).
Treatment goals are to return to activities as soon as is safely possible. Returning too soon may worsen the injury. Use RICE (rest, ice, compression, and elevation). Resting and avoiding activities that may have started the problem are critical. Apply ice packs or do ice massages for up to 20 minutes, three times a day, for 2 to 3 days or until the pain is gone. Special stretching and strengthening exercises such as toe raises often help. Raise the leg with pillows. A physical therapist may be involved in treatment. Other measures include wearing proper shoes with arch supports (orthotics), cross-training (stationary bicycling or pool running), doing range-of-motion exercises, and slowly increasing running activities.
Nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, acetaminophen, aspirin) may relieve pain but can cause stomach problems and should be taken with meals.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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