Symptoms & Treatments

Shin Splints

Overuse syndromes are very common in running athletes. While occasionally seen in individuals involved in a regular training program, they are more commonly encountered at the beginning of the training season. Each spring, people return to running as a form of aerobic exercise and typical overuse syndromes occur.

One of the most common conditions evaluated on a regular basis every spring and summer is a problem generically known as shin splints. This is seen more commonly in distance runners and sprinters and is occasionally seen in jumping athletes. Most of the pain occurs after the first few weeks of training. This is usually a result of a sudden change in activities, stressing the previously non-exercised muscles. The pain is localized to the lower inner portion of the shin, known as the posterior medial corner of the tibia. This is the site of attachment of major muscle groups which help support the foot and arch. The pain is believed to be secondary to inflammation at the musculature attachment to bone. This inflammation is the result of a partial tearing and stressing of the muscle-to-bone attachment. Pain is aggravated by athletic activities. Rarely, there is some swelling in the area, and it is uncommon for any bruising to develop.

The athlete is very tender over the lower portion of the leg on examination. There usually is discomfort with testing of the lower leg muscle strength. X-rays of the area are usually unremarkable. Specialized testing known as a bone scan, which measures blood flow to the bone, reveals some increased circulation to the affected area.

Treatment is basically conservative, with activity modifications, physical therapy, and anti-inflammatory medication. Physical therapy modalities are directed at decreasing the inflammation and returning normal motion through the foot, ankle, and knee. Selective stretching followed by strengthening exercises are then performed.

Occasionally, molded inserts are used for athletic shoes to help support the arch and decrease the stress on the affected muscles. Only rarely is surgery indicated for this condition. With proper stretching and cooling-down techniques, symptoms will usually resolve within a few weeks and allow the resumption of normal training.