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PATIENT GUIDE TO SHIN SPLINTS

The term “shin splints” refers to pain along or just behind the shinbone (tibia) — the large bone in the front of your lower leg. Medically known as medial tibial stress syndrome, shin splints occur during physical activity and result from too much force being placed on your shinbone and connective tissues that attach your muscles to the bone. Shin splints are common in runners and in those who participate in activities with sudden stops and starts, such as basketball, soccer or tennis.

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. Wearing proper footwear and modifying your exercise routine can help prevent shin splints from recurring.

SYMPTOMS OF SHIN SPLINTS:

If you have shin splints, you may notice:

  • Tenderness, soreness or pain along the inner part of your lower leg
  • Mild swelling in your lower leg

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 OF SHIN SPLINTS:

Shin splints are caused by excessive force (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 errors, such as engaging in a running program with the “terrible toos” — running too hard, too fast or for too long.

RISK FACTORS OF SHIN SPLINTS:

You’re more at risk of shin splints if:

  • You’re a runner, especially just beginning a running program
  • You have flat feet or rigid arches, causing your feet to roll inward when running
  • You increase the intensity of your workouts by doing more high-impact activities
  • You play sports on hard surfaces, with sudden stops and starts
  • You’re in military training

TEST AND DIAGNOSIS OF SHIN SPLINTS

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 identify other possible causes for your pain, such as a stress fracture — tiny cracks in a bone often caused by overuse.

PREVENTION:

To help 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 (560 to 800 kilometers).
  • 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 calf muscles, 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.

GET PROFESSIONAL OPINION AND TREATMENT ABOUT YOUR SHIN SPLINT. CALL +65 64712744 or SMS to +65 92357641 FOR APPOINTMENT

Muscle Strain

Muscle strain or muscle pull or even a muscle tear implies damage to a muscle or its attaching tendons. You can put undue pressure on muscles during the course of normal daily activities, with sudden, quick heavy lifting, during sports, or while performing work tasks.

Muscle damage can be in the form of tearing (part or all) of the muscle fibers and the tendons attached to the muscle. The tearing of the muscle can also damage small blood vessels, causing local bleeding (bruising) and pain (caused by irritation of the nerve endings in the area).

Muscle Strain Symptoms

  • Swelling, bruising or redness, or open cuts as a consequence of the injury
  • Pain at rest
  • Pain when the specific muscle or the joint in relation to that muscle is used
  • Weakness of the muscle or tendons (Asprain, in contrast, is an injury to a joint and its ligaments.)
  • Inability to use the muscle at all

When to Seek Medical Care

If you have a significant muscle injury (or if the home care methods bring no relief in 24 hours), call your doctor.

If you hear a “popping” sound with the injury, cannot walk, or there is significant swelling, pain, fever, or open cuts, you should be examined in a hospital’s emergency department.

Exams and Tests

The doctor will take a medical history and perform a physical exam. On exam, it is important to establish whether the muscle is partially or completely torn (which can involve much longer healing, possible surgery, and a more complicated recovery).

X-rays or laboratory tests are often not necessary, unless there was a history of trauma or evidence of infection.

Self-Care at Home

The amount of swelling or local bleeding into the muscle (from torn blood vessels) can best be managed early by applying ice packs and maintaining the strained muscle in a stretched position. Heat can be applied when the swelling has lessened. However, the early application of heat can increase swelling and pain.

Note: Ice or heat should not be applied to bare skin. Always use a protective covering such as a towel between the ice or heat and the skin.

  • Take nonsteroidal anti-inflammatory agents such as aspirin and ibuprofen to reduce the pain and to improve your ability to move around.
  • Protection, rest, ice, compression, and elevation (known as the PRICE formula) can help the affected muscle. Here’s how: First, remove all constrictive clothing, including jewelry, in the area of muscle strain.
    • Protect the strained muscle from further injury.
    • Rest the strained muscle. Avoid the activities that caused the strain and other activities that are painful.
    • Ice the muscle area (20 minutes every hour while awake). Ice is a very effective anti-inflammatory and pain-relieving agent. Small ice packs, such as packages of frozen vegetables or water frozen in foam coffee cups, applied to the area may help decrease inflammation.
    • Compression can be a gently applied with an Ace or other elastic bandage, which can provide both support and decrease swelling. Do not wrap tightly.
    • Elevate the injured area to decrease swelling. Prop up a strained leg muscle while sitting, for example.
  • Activities that increase muscle pain or work the affected body part are not recommended until the pain has significantly gone away.

Medical Treatment

Treatment is similar to the treatment at home. The doctor, however, also can determine the extent of muscle and tendon injury and if crutches or a brace is necessary for healing. The doctor can also determine if you need to restrict your activity, take days off work, and if rehabilitation exercises are required to help you recover.

Prevention

  • Avoid injury by daily stretching.
  • Stretch every time before you exercise.
  • Establish a warm-up routine prior to engaging in strenuous exercise.
  • Start an exercise program in consultation with our doctor.

To schedule for an appointment, call us at +65 6471 2744 / Email: info@boneclinic.com.sg

Muscle Strain

Muscle strain or muscle pull or even a muscle tear implies damage to a muscle or its attaching tendons. You can put undue pressure on muscles during the course of normal daily activities, with sudden, quick heavy lifting, during sports, or while performing work tasks.

Muscle damage can be in the form of tearing (part or all) of the muscle fibers and the tendons attached to the muscle. The tearing of the muscle can also damage small blood vessels, causing local bleeding (bruising) and pain (caused by irritation of the nerve endings in the area).

Muscle Strain Symptoms

  • Swelling, bruising or redness, or open cuts as a consequence of the injury
  • Pain at rest
  • Pain when the specific muscle or the joint in relation to that muscle is used
  • Weakness of the muscle or tendons (A sprain, in contrast, is an injury to a joint and its ligaments.)
  • Inability to use the muscle at all

Muscle Strain Treatment Self-Care at Home

The amount of swelling or local bleeding into the muscle (from torn blood vessels) can best be managed early by applying ice packs and maintaining the strained muscle in a stretched position. Heat can be applied when the swelling has lessened. However, the early application of heat can increase swelling and pain.

Note: Ice or heat should not be applied to bare skin. Always use a protective covering such as a towel between the ice or heat and the skin.

  • Take nonsteroidal anti-inflammatory agents such as aspirin and ibuprofen to reduce the pain and to improve your ability to move around.
  • Protection, rest, ice, compression, and elevation (known as the PRICE formula) can help the affected muscle. Here’s how: First, remove all constrictive clothing, including jewelry, in the area of muscle strain.
    • Protect the strained muscle from further injury.
    • Rest the strained muscle. Avoid the activities that caused the strain and other activities that are painful.
    • Ice the muscle area (20 minutes every hour while awake). Ice is a very effective anti-inflammatory and pain-relieving agent. Small ice packs, such as packages of frozen vegetables or water frozen in foam coffee cups, applied to the area may help decrease inflammation.
    • Compression can be a gently applied with an Ace or other elastic bandage, which can provide both support and decrease swelling. Do not wrap tightly.
    • Elevate the injured area to decrease swelling. Prop up a strained leg muscle while sitting, for example.
  • Activities that increase muscle pain or work the affected body part are not recommended until the pain has significantly gone away.

Medical Treatment

Treatment is similar to the treatment at home. The doctor, however, also can determine the extent of muscle and tendon injury and if crutches or a brace is necessary for healing. The doctor can also determine if you need to restrict your activity, take days off work, and if rehabilitation exercises are required to help you recover.

Next Steps Prevention

  • Avoid injury by daily stretching.
  • Stretch every time before you exercise.
  • Establish a warm-up routine prior to engaging in strenuous exercise.
  • Start an exercise program in consultation with your doctor.

Muscle Spasms and Cramps

If you’ve ever had muscle spasms or muscle cramps, you know they can be extremely painful. In some cases, a muscle may spasm so forcefully that it results in a bruise on the skin. Most muscle spasms and cramps are involuntary contractions of a muscle. A serious muscle spasm doesn’t release on its own and requires manual stretching to help relax and lengthen the shortened muscle. Spasms and cramps can be mild or extremely painful. While they can happen to any skeletal muscle, they are most common in the legs and feet and muscles that cross two joints (the calf muscle, for example). Cramps can involve part of a muscle or all the muscles in a group. The most commonly affected muscle groups are:
•Back of lower leg / calf (gastrocnemius).
•Back of thigh (hamstrings).
•Front of thigh (quadriceps).
•Feet, hands, arms, abdomen

Muscle cramps range in intensity from a slight twitch or tic to severe pain. A cramped muscle can feel rock-hard and last a few seconds to several minutes or longer. It is not uncommon for cramps to ease up and then return several times before they go away entirely.

What Causes Muscle Cramps
The exact cause of muscle cramps is still unknown, but the theories most commonly cited include:
•Altered neuromuscular control
•Dehydration
•Electrolyte depletion
•Poor conditioning
•Muscle fatigue
•Doing a new activity

Other factors that have been associated with muscle cramps include exercising in extreme heat. The belief is that muscle cramps are more common during exercise in the heat because sweat contains fluids as well as electrolyte (salt, potassium, magnesium and calcium). When these nutrients fall to certain levels, the incidence of muscle spasms increases. Because athletes are more likely to get cramps in the preseason, near the end of (or the night after) intense or prolonged exercise, some feel that a lack of conditioning results in cramps.

According to a review of the literature conducted by Martin Schwellnus from the University of Cape Town, the evidence supporting both the “electrolyte depletion” and “dehydration” hypotheses as the cause of muscle cramps is not convincing. He reviewed the available literature supporting these theories and found mostly anecdotal clinical observations and one small case-control study with only 10 subjects. He also found another four clinical prospective cohort studies that clearly did not support the “electrolyte depletion” and “dehydration” hypotheses as the cause of muscle cramps. In his review, Schwellnus concludes that the “electrolyte depletion” and “dehydration” hypotheses do not offer plausible pathophysiological mechanisms with supporting scientific evidence that could adequately explain the clinical presentation and management of exercise-associated muscle cramping.

Treating Muscle Cramps
Cramps usually go away on their own without treatment, but these tips appears to help speed the healing process:
•Stop the activity that caused the cramp.
•Gently stretch and massage the cramping muscle.
•Hold the joint in a stretched position until the cramp stops.

Preventing Muscle Cramps
Until we learn the exact cause of muscle cramps, it will be difficult to say with any confidence how to prevent them. However, these tips are most recommended by experts and athletes alike:
•Improve fitness and avoid muscle fatigue
•Stretch regularly after exercise
•Warm up before exercise
•Stretch the calf muscle: In a standing lunge with both feet pointed forward, straighten the rear leg.
•Stretch the hamstring muscle: Sit with one leg folded in and the other straight out, foot upright and toes and ankle relaxed. Lean forward slightly, touch foot of straightened leg. (Repeat with opposite leg.)
•Stretch the quadriceps muscle: While standing, hold top of foot with opposite hand and gently pull heel toward buttocks. (Repeat with opposite leg.)

Most muscle cramps are not serious. If your muscle cramps are severe, frequent, constant or of concern, see your doctor.