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Updated 13 February 2013

Shin splints

Shinsplints refers to the pain experienced in the lower shinbone.

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  • Shin splints refers to the pain experienced in the lower shinbone
  • Shin splints are not only confined to the bone
  • Anyone performing pounding-type exercises with the legs can be affected

What are shin splints?
Shin splints is the colloquial name given to pain that is experienced in the lower shinbone (tibia), more commonly in the front of the leg than at the back or the sides.

The name arose from joggers and runners who commonly describe the pain as though the shinbone were “splintering” during exercise.

The leg muscles attached to the shinbone become inflamed and injured at the attachment. Shin splints are therefore not a condition of the bone.

A stress fracture needs to be ruled out by repeating an X-ray two weeks later, or by doing a bone scan. A stress fracture is a far more serious injury and means that part of the bone has developed micro-tears or a hairline crack, and will require a six to eight week period of healing.

Who gets shin splints?
Shin splints are not confined to runners alone - anyone performing pounding-type exercises with the legs, like aerobics, tennis or even ballet dancers can experience this affliction.

Causes of shin splints
There are many different causative factors that can lead to injuries like shin splints.

  • Overuse, (i.e. doing too many exercise sessions per week or exercising for too long).
  • Running on hard surfaces.
  • Biomechanical factors, such as excessive pronation (inward rolling of the foot) or supination (outward rolling).
  • Stiff, tight or weak calf or lower leg muscles.
  • Hard or worn out shoes. These shoes no longer provide adequate shock absorptive capacities, and thus increased stress is applied to the shinbone.
  • Improper stretching or a lack of correct stretching exercises.
  • An inadequate warm-up routine.
  • Training too hard, too fast, too soon. When starting out with an exercise programme, one should allow at least eight to 12 weeks for the body to adapt and the muscles, tendons and bones to strengthen. Failure to do this can lead to bone injuries like shin splints.
  • Increasing mileage too quickly, and not allowing for adequate adaptation.
  • Dietary factors, e.g. too little calcium intake can lead to a weakened bone structure.
  • Hormonal factors in women.

What are the symptoms?

  • Pain on the inside of the shinbone when running or exercising.
  • Lumps and bumps over the bone may indicate swelling and inflammation.
  • Excruciating pain when tapping or pressing directly onto the shinbone with your thumb. (Could also be a stress fracture.)
  • Some swelling on the inside edge, lower third of the shinbone.
  • Pain with resistance tests for the muscles attached to the bone and when standing on your toes.
  • Muscle spasm on inside shin muscles.

If your pain starts during running after a particular time or distance, the problem may be a compartment syndrome injury, which can be a more severe problem, and for which you must consult your doctor or a specialist.

What you can do about shin splints

  • Apply the RICE principle: rest - slows down bleeding, allows healing and reduces the risk of further damage; ice - eases pain, reduces swelling, reduces bleeding initially; compression - reduces bleeding and swelling; elevation - reduces bleeding and swelling and promotes healing by allowing fluids to flow away from the site of injury.
  • See a sports injury specialist such as a sports physiotherapist or sports medicine doctor.
  • If you have increased your exercise sessions or mileage recently, then cut it down a little to allow your shinbone to recover and heal.
  • Shin splints are not as serious an injury as a stress fracture, but they often have similar symptoms. If your shin pain continues after three or more weeks or worsens to the point where you can’t run or hop on your sore leg, you should consider seeing you doctor to rule out a stress fracture.
  • See a podiatrist to get some orthotics to wear inside your shoes to rectify any biomechanical factors. A simple pair of shock absorbing inner soles may be all that is required to help cushion your shinbones.

(Reviewed by Dr Sirk Loots, orthopaedic surgeon)

 
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