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Shin
Splints
Definition
Whether you're running after a soccer ball, jogging around
the neighborhood park or training for a race, you're at risk of
a common, running-related injury called shin splints (medial
tibial stress syndrome).
The term "shin splints" refers to pain along the shinbone
(tibia) — the large bone in the front of your lower leg. The
pain is caused by an overload on the shinbone and the connective
tissues that attach your muscles to the bone.
The risk of shin splints is no reason to give up your morning
jog or afternoon aerobics class. Most cases of shin splints can
be treated with rest, ice and other self-care measures — and
wearing proper footwear and modifying your exercise routine can
help prevent shin splints from recurring.
Symptoms
If you have shin splints, you may notice:
- Tenderness, soreness or pain along the inner part of
your lower leg
- Mild swelling
At first, the pain may stop when you stop running or
exercising. Eventually, however, the pain may be continuous.
When to see a doctor
Consult your doctor if rest, ice and over-the-counter pain
relievers don't ease your shin pain. Your primary care doctor
may refer you to an orthopedist. Seek prompt medical care if:
- Severe pain in your shin follows a fall or accident
- Your shin is hot and inflamed
- Swelling in your shin seems to be getting worse
- Shin pain persists during rest
Causes
Shin splints are caused by an overload on the shinbone and
the connective tissues that attach your muscles to the bone. The
overload is often caused by specific athletic activities, such
as:
- Running downhill
- Running on a slanted or tilted surface
- Running in worn-out footwear
- Engaging in sports with frequent starts and stops, such
as basketball and tennis
Shin splints can also be caused by training too hard, too
fast or for too long.
Risk factors
Shin splints are most common among runners, particularly
those just starting a running program. If you have flat arches,
your feet may have a tendency to roll too far inward (pronate)
when running — which can contribute to shin splints.
Tests and diagnosis
Shin splints are usually diagnosed based on your medical
history and a physical exam. In some cases, an X-ray or other
imaging studies can help the doctor rule out other conditions,
such as a stress fracture — tiny cracks in a bone often caused
by overuse.
Treatments and drugs
In most cases, you can treat shin splints with simple
self-care steps:
- Rest. Avoid
activities that cause pain, swelling or discomfort — but
don't give up all physical activity. While you're healing,
try low-impact exercises, such as swimming, bicycling or
water running. If your shin pain causes you to limp,
consider using crutches until you can walk normally without
pain.
- Ice the affected area.
Apply ice packs to the affected shin for 15 to 20 minutes at
a time, four to eight times a day for several days. To
protect your skin, wrap the ice packs in a thin towel.
- Reduce swelling.
Elevate the affected shin above the level of your heart,
especially at night. It may also help to compress the area
with an elastic bandage or compression sleeve. Loosen the
wrap if the pain increases, the area becomes numb or
swelling occurs below the wrapped area.
- Take an over-the-counter
pain reliever. Try ibuprofen (Advil, Motrin,
others), naproxen (Aleve), aspirin or acetaminophen
(Tylenol, others) to reduce pain.
- Wear proper shoes.
Your doctor may recommend a shoe that's especially suited
for your foot type, your stride and your particular sport.
- Consider arch supports.
Arch supports can help cushion and disperse stress on your
shinbones. Off-the-shelf arch supports come in various sizes
and can be fitted immediately. More durable arch supports
can be custom-made from a plaster cast of your foot.
It's also important to resume your usual activities
gradually. If your shin isn't completely healed, returning to
your usual activities may only cause continued pain.
Prevention
To prevent shin splints:
- Choose the right shoes.
Wear footwear that suits your sport. If you're a runner,
replace your shoes about every 350 to 500 miles.
- Consider arch supports.
Arch supports can help prevent the pain of shin splints,
especially if you have flat arches.
- Lessen the impact.
Cross-train with a sport that places less impact on your
shins, such as swimming, walking or biking. Remember to
start new activities slowly. Increase time and intensity
gradually.
- Add strength training to
your workout. To strengthen your shins, try toe
raises. Stand up. Slowly rise up on your toes, then slowly
lower your heels to the floor. Repeat 10 times. When this
becomes easy, do the exercise holding progressively heavier
weights. Leg presses and other exercises for your lower legs
can be helpful, too.
It's also important to know when to rest; at the first sign
of shin pain, take a break.
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