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Shin Splints

Shin Splints are a very common problem that occurs when exercising. Whether old or young, shin splints can happen to any individual who is participating in physical activity. Shin splints can be resolved through at-home remedies and only in the rarest of cases will need surgery. Ensuring that you are not pushing your body’s limits in exercise is the main way to avoid shin splints from reoccurring.

ANATOMY

Shin splints are caused by pain along the inner edge of the shinbone (tibia), also known as medial tibial stress syndrome. Pain occurs when the muscles, tendons and bone tissue around the tibia become worn or inflamed due to physical activity or exercise.

Shin Splints

The inner border of the tibia where the muscles attach to bone is generally where pain will occur. The tibia (shinbone) is on the inner edge part of the leg, while the fibula is on the outer edge part of the leg. Both bones work together with the muscles, tendons and other leg parts to provide motion and support.

DESCRIPTION

Runners, dancers, and military recruits are a few groups who are regularly get shin splints. When the muscle and bone tissue (periosteum) become overworked from intense physical activity, shin splints can develop. Although not serious, they can hinder your enjoyment of exercise and day-to-day activity if not evaluated.

Shin splints come about after unusual or sudden changes in activity – from starting a new workout routine or playing a different sport than you’re used to.

Other factors that can contribute to shin splints include:

  • Having flat feet
  • Exercising in improper or ill-fitting footwear
  • Having abnormally rigid arches

Flat feet create stress that can cause shin splints if your stance is not corrected. Changes in intensity or length of exercise also can play a role in adding stress to your shin.

SYMPTOMS

Shin splints can occur before, during and after exercise. Although not considered to be a severe injury, they can be painful depending on the intensity of the stress on your shinbone.

Pain may range from a dull ache to throbbing and shooting along the border of the tibia. Mild swelling can occur, but it is less likely if it is only a minor injury. Pain may be aggravated if the sore spot is touched, as it is likely to be tender.

DIAGNOSIS

During a physical examination, your Florida Orthopaedic Institute physician will ask about your symptoms and medical history. Your physician will check for tenderness of the area and may order imaging tests depending on severity to better see the damage done.

Although shin splints themselves are minor issues, it is important for your physician to carefully examine the area to ensure no other problems are present. Such problems can include:

  • Stress Fracture: A small crack or cracks in the tibia caused by overuse. Imaging tests such as an x-ray, CT (Computerized Tomography) scan or MRI (Magnetic Resonance Imaging) may be ordered to rule out the presence of stress fractures.
  • Tendinitis: The inflammation of the tendons that attach muscles to bones. Pain may be caused by partial tears of the tendon. MRI imaging tests can determine if there are tears present in the tendons.
  • Chronic Exertional Compartment Syndrome: A rare condition that mimics the symptoms of shin splints. Caused by built-up pressure within the muscle, chronic exertional compartment syndrome occurs with intense exercise. Although painful, this condition normally subsides after the physical activity has stopped and can be diagnosed through a pressure test.

Your physician will talk through your options with you should they suspect that you have any of these more serious conditions.

TREATMENT

Since shin splints can usually resolve themselves either alone or with at-home remedies, treatment is basic.

Shin splints come about after overuse during intense physical activity, so most standard treatments include some degree of rest to let the injury heal. Your physician may also tell you take over-the-counter medication to relieve any pain or swelling of the area.

NON-SURGICAL TREATMENTS

The Florida Orthopaedic Institute’s philosophy is to first try all appropriate nonsurgical methods to increase mobility and function. Shin splints heal naturally if there isn’t any added stress to hinder the healing process.

  • Rest: The most important factor in healing is to avoid high-intensity exercise or sport. Physical activities with little-to-no impact on the feet such as swimming or a stationary bike are recommended while recovering from shin splints.
  • Ice: Using cold packs for 20 minutes at a time, multiple times per day, can help with swelling. Please remember to never apply ice directly to the skin.
  • Compression: Your physician may recommend you wear an elastic compression bandage to prevent additional swelling and get you back on your feet quicker.
  • Flexibility Exercises: Gentle stretching of the lower leg muscles introduced gradually can reduce stress in the shins.
  • Over-the-counter Medicine: Non-steroidal anti-inflammatory medicines such as ibuprofen (Advil, Motrin) and aspirin can assist with pain reduction.
  • Supportive Shoes: Your physician may recommend wearing shoes with more cushioning in them to support your shins as they heal.
Shin Splints

Occasionally, individuals may be prone to recurrent shin splints or have flatter feet than others. In cases like these, your physician may recommend shoe inserts. These extra-cushiony and low-stress inserts can be custom-made to fit your foot or purchased in stores.

Your Florida Orthopaedic Institute physician will instruct you when it is acceptable to return to exercise. This will be a gradual process, as it is important not to disrupt healing. Before returning to exercise, you should be without pain for at least 2 weeks. You will also be advised to not return immediately to a regular high-intensity routine or workout.

Warming up and stretching are key to a positive recovery. Shin splints can resolve themselves within a few weeks with proper rest and low-intensity movement, but if you do feel any pain as you return to exercise, it is advised to stop immediately and ice the area. Slow training and gradual intensity are essential to avoiding shin splints in the future.

SURGICAL PROCEDURES/TREATMENTS

It is very rare to need surgical treatment for shin splints. Since almost all shin splint injuries can be resolved naturally through rest, there are very few surgical options available.

Surgery can be done in the rarest of instances, but that is only in the case that your injury does not respond to nonsurgical treatment. Your Florida Orthopaedic Institute physician will discuss options with you about any problems that may need surgical attention.

NEXT STEPS

If you think you have shin splints, call Florida Orthopaedic Institute to schedule an appointment for an evaluation. All Florida Orthopaedic Institute surgeons are fellowship trained, adding additional expertise in their specialty. They stay current on the latest shin splint research and treatments and will discuss all your treatment options.

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