ANSWERS: 1
  • <div class="section1"> Definition

    Shin splints refer to the sharp pains that occur down the front of the lower leg. They are a common complaint, particularly among runners and other athletes.

    Description

    Shin splints may refer to a number of lower leg complaints and injuries. In most cases, shin splints refer to the pain that results from overload on the tissues that connect muscles to the shin bone (tibia). They also may come from the small bone of the lower leg and ankle, called the fibula. The medical term for shin splints is medial tibial stress syndrome.

    Next to ankle sprains, shin splints are probably the most common complaint of injury to the lower body. Most shin splints occur in the front (anterior) portion of the tibia; some also occur in the inside of the leg along the tibia. Runners probably suffer shin splints more than other people, but they also occur in people who play basketball and tennis and those who walk long distances, particularly on treadmills.

    Causes and symptoms

    The most common cause of shin splints is overdoing activities that constantly pound on the legs and feet. This may include sports with many stops and starts, running down hills or other tilted surfaces, or repeated walking. Simply training too long or too hard, especially without proper stretching and warm-up, can cause shin splints. People with flat feet, high arches, or feet that turn outward may be more prone to shin splints. Shoes that are worn or don’t provide proper foot support also add to the problem.

    Diagnosis

    The physician will check the leg for tenderness. If the pain is in a single area of the tibia and hurts to the touch, the cause may by a stress fracture. The physician may order an x ray to rule out a stress fracture, but shin splints often can be diagnosed without x rays.

    Treatment

    Physicians usually recommend a period of rest for people with shin splints to let the area heal. Usually, about three to four weeks is recommended, though the time varies depending on the patient and injury severity. Shin splints may be treated in phases, beginning with absolute rest and gradual return to activity. Ice and elevation of the foot may be used to help relieve pain and swelling in the first phase. If the person needs to keep in shape, stretching and water exercises that keep the foot from bearing weight may be allowed after initial treatment. As the patient returns to normal function, orthotic footwear and braces may be added to prevent re-injury.

    Alternative treatment

    Various massage techniques may help speed up recovery. Homeopathic physicians may recommend Rhus tox. Those using alternative remedies should ensure they are certified practitioners and should coordinate care with allopathic providers.

    Prognosis

    With proper rest, management, and prevention, people with shin splints can return to normal activity in a few weeks or more. However, continuing to perform the activity that caused the shin splints can lead to stress fractures of the tibia.

    Prevention

    Re-injury is most common in the first month after return to normal activity, and patients who have had shin splints should return to previous activities cautiously. The following can help prevent shin splints from occurring in people who run and perform stop and start physical activities:

    • Warming up and stretching calf muscles before running or jogging. A podiatrist specializing in sports medicine or other sports medicine specialist may recommend specific stretching exercises.
    • Strengthening muscles in the front lower leg (anterior tibialis) with resistance exercises or by walking on the heels three times daily for about 30 yards.
    • Wearing quality shoes with arch supports. Runners should purchase new shoes about every 400 miles. A podiatrist can design special arch supports or orthotics for people with flat feet.
    • Runs should be started at a slow pace and gradually increased.
    • Athletes can cross-train in a sport that does not impact the feet and lower legs as much, such as swimming or riding a bicycle.

    Source: The Gale Group. Gale Encyclopedia of Medicine, 3rd ed.

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