Shin Splints – pain in leg along shin bone

Shin splints refers to pain along the inner edge of the shin bone (tibia) usually extending from knee to ankle. This condition is seen in physically active individual when there is change in frequency, duration and intensity of exercises. This can also begin with abrupt start of a game which involves leg movements without proper warm up, or improper shoes. Other factors that contribute to this condition are flat foot and abnormally rigid arch of foot.

Symptoms of shin splints

Usually an individual with shin splints will present with pain along the border of the tibia extending from knee to ankle. May also complain mild swelling in the area.

Shin splint pain may be aggravated by touching the sore spot, will be dull and throbbing or sharp pain. Pain may occur both during and after exercise.

Clinical examination

Examination is done to rule out other conditions causing shin pain

Stress fracture:

A stress fracture is a small crack(s) in the tibia caused by stress and overuse. Clinically one has to rule out stress fracture if shin splints are not responsive to treatment. Tenderness in localised area and X-ray, bone scan or MRI may help to arrive at diagnosis.

Compartment syndrome

This is painful condition when pressure within the muscle increases to dangerous levels. The pain decreases/resolves after stopping exercise/activity. This usually is caused by over exertion leading to edema of muscle compartment and hence increased pressure in the closed compartment. Usually diagnosed by measuring the pressure in the muscle compartment.

Tendinitis

This is also a painful condition like Shin splints. In this there will be inflammation of tendons (tissue that connects muscle to bone) Can be ruled out by MRI if needed.

Treatment

Most of the cases will be managed medically with NSAIDs (pain killers), Ice packs (not to apply ice directly over skin), elastic compression bandage, rest and using proper supportive shoes.

Very few cases where the pain has not relieved even after medical management then some relief can be attained by fasciotomy (surgical procedure where small cuts are made in fascia, a sheet like lining).

Return to exercise

Before returning to exercise, there should be a pain-free period of at least 2 weeks. The exercise must be at a lower level of intensity and at lower frequency

Be sure to warm up and stretch thoroughly before you exercise. Increase training slowly. If you start to feel the same pain, stop exercising immediately. Use a cold pack and rest for a day or two. Return to training again at a lower level of intensity. Increase training even more slowly than before.