Shin Splints

GENERAL INFORMATION:

What is it? Shin splints is a painful condition that affects the lower leg between the knee and the ankle. It is caused by damage to the muscles, tendons and tissues that attach to the lower leg bones. This damage leads to inflammation (in-flah-MAY-shun) (redness, swelling and pain) in the lower leg. Shin splints may also be called medial tibial stress syndrome (SIN-drohm). With treatment, it may take one to six weeks or longer for your shin splints to go away.

What causes shin splints? Some common causes of shin splints are as follows:

• Not stretching and warming up your muscles enough before exercising.
  
  
• Overpronation (over-proh-NAY-shun). This happens when your foot rolls inward too much when you run.
  
  
• Over-use or over-training. Shin splints can be caused by training or working out too much after not exercising for a while. They can be caused by adding sudden increases in time or distance to your athletic training. Shin splints may be caused by doing activities that use repeated movements. These activities include running and standing for long time periods.
  
  
• Shoes that do not fit or support the foot well.
  
  
• Stress to the lower leg. This can be caused by jumping a lot or running often on hard surfaces such as concrete or asphalt. This can be caused by some muscles in your legs being stronger than the others. Having high arches or flat feet can put stress on the tendons and muscles of the shins.

What are the signs and symptoms? You may have pain in the inner side and back part of your shin. You may have pain in the front and outer side of your shin. You may also have dull aching, tenderness and swelling.

• You may first feel shin pain when beginning to run or exercise. The pain usually goes away as your muscles warm up, but it may come back after exercising.
  
  
• If it is not treated, shin pain can become constant. You may have pain while exercising and even when you are resting your legs.

How are shin splints diagnosed? A caregiver will examine your shin and ask you questions about your activities. You may need x-rays, bone scans or magnetic resonance (REZ-oh-nans) imaging (MRI). These tests will show a picture of the bones and tissues inside your lower leg. Caregivers can do these tests to learn if you have a stress fracture (FRAK-chur) (crack in your bone). They may also look for other problems.

How are shin splints treated?

• Rest: The most important part of treating shin splints is to rest your shin. Rest may help decrease swelling and keep your shin splints from getting worse. Your caregiver can help you plan how to rest your shins. You may need to decrease your training time and distance until your shin is better. You may need to stop the activities that caused your shin splints until your shin heals. Caregivers can tell you about other exercises, such a bicycling or swimming, to do while your shin heals.
  
  
• Ice: Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain, and redness). You may massage your shin with ice or put an ice bag on it.
  
  
  • To ice massage, fill a paper cup with water and freeze to make a large ice cube. Peel the paper away and put the ice cube on your injured shin. Rub in circles using medium pressure for five to ten minutes, three to four times each day.
    
    
  • To make an ice bag, put crushed ice in a plastic bag or use a bag of frozen corn or peas. Cover it with a towel. Put this on your shinbone for 15 to 20 minutes, three to four times each day. Do not sleep on the ice pack because you can get frostbite.
  
  
• Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). Some NSAIDs may also be used to decrease a high body temperature (fever). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
  
  
• Physical therapy: Physical (FIZ-i-kal) therapists (THER-ah-pists) can help you with special exercises and treatments to help your shin splints heal faster. Exercises to make your leg muscles stronger and more flexible will be started after the shin splints have healed.
  
  
• Shoe inserts: You may need to wear specially-made orthotics (or-THOT-iks) or over-the-counter inserts in your shoes. These may be rubber, silicone or felt pads for your heel, arch or the entire sole (bottom) of your foot. These may give the control, support or padding that is needed to decrease stress on your shins.
  
  
• Stretching and strengthening exercises: Your caregiver may tell you to do stretches and special exercises at home. Stretching and making certain muscles stronger may help decrease stress on your shins
  
  
• Surgery: You may need surgery if your shin is very damaged and does not heal with other treatments.
  
  
• Taping: You may need to wrap special tape around your shin to decrease pain and provide support.

How can I help prevent shin splints? Following are some things you can do to help keep you from getting shin splints again.

• Wear shoes that fit correctly and support your feet. Replace your running or exercise shoes before the padding or shock absorption is worn out. Shock absorption greatly decreases as the treads on the bottoms or sides of your shoes begin to wear down. You may need running shoes that give your foot special heel or arch support. You may need shoe inserts to keep your foot from rolling inward too much (overpronation). Ask your caregiver which exercise shoes, inserts or specially-made orthotics are right for you.
  
  
• Start exercising when caregivers say that it is OK. Slowly start your exercise or training program as directed by your caregiver. If you are a runner, you may need to start by running shorter times and distances. Then you can increase your training in time.
  
  
• Stretch before exercising. Always warm up your muscles and stretch gently before exercising. Do cool down exercises when you are finished. This will loosen your muscles and decrease stress on your shin.
  
  
• Exercise the right way. If you are a runner, increase your time and distance slowly over time. If your shin splints are caused by the way that you exercise, ask a trainer, coach, or caregiver for help. They can teach you ways to train or exercise to help prevent shin splints. For example, you may be told to avoid running on uneven or slanting surfaces. Do not run or exercise on surfaces that are very hard, such as asphalt or concrete. Instead, run on softer surfaces such as rubber tracks, grass or evenly packed dirt tracks.
  
  
• Use ice after your workouts. Put ice on your shins after exercising or if you begin to feel shin splint pain. Rest your shins, and use ice packs. Ask your caregiver about using anti-inflammtory medicine (NSAIDs).

Call your caregiver if:

• Your pain and swelling increase.
  
  
• You develop new, unexplained symptoms.
  
  
• You have a temperature over ____.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about shin splints. You can then discuss treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.

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