Definition of Shin Splints / Medial Tibial Stress Syndrome

Shin splints are injuries to the front of the outer leg. While the exact injury is not known, shin splints seem to result from inflammation due to injury of the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer leg.

Shin splints are a member of a group of injuries called “overuse injuries.” Shin splints occur most commonly in runners or aggressive walkers.

What are Shin splints symptoms?

Shin splints cause pain in the front of the outer leg below the knee. The pain of shin splints is characteristically located on the outer edge of the mid region of the leg next to the shinbone (tibia). An area of discomfort measuring 4-6 inches (10-15 cm) in length is frequently present. Pain is often noted at the early portion of the workout, then lessens, only to reappear near the end of the training session. Shin splint discomfort is often described as dull at first. However, with continuing trauma, the pain can become so extreme as to cause the athlete to stop workouts altogether.

What causes Shin Splints?

A primary culprit causing shin splints is a sudden increase in distance or intensity of a workout schedule. This increase in muscle work can be associated with inflammation of the lower leg muscles, those muscles used in lifting the foot (the motion during which the foot pivots toward the tibia). Such a situation can be aggravated by a tendency to pronate the foot (roll it excessively inward onto the arch).

Similarly, a tight Achilles tendon or weak ankle muscles are also often implicated in the development of shin splints.

How are Shin Splints diagnosed?

The diagnosis of shin splints is usually made during examination. It depends upon a careful review of the patient’s history and a focused physical exam (on the examination of the shins and legs where local tenderness is noted).

Specialized (and costly) tests (for example, bone scans) are generally only necessary if the diagnosis is unclear. Radiology tests, such as X-rays, bone scan, or MRI scan, can be helpful in this setting to detect stress fracture of the tibia bone.

What is the treatment of shin splints?

Previously, two different treatment management strategies were used: total rest or a “run through it” approach. The total rest was often an unacceptable option to the athlete. The run through it approach was even worse. It often led to worsening of the injury and of the symptoms.

Currently, a multifaceted approach of “relative rest” is successfully utilized to restore the athlete to a pain-free level of competition.

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