Diagnosing And Treating Exercise Induced Shin Splints

. If you enjoy running or walking on your treadmill, chances are at some point you have felt a sharp, painful tightness in your shins. This can be very irritating, and is often hard to get rid of.

Shin splints are injuries to the front of the outer leg. While the exact injury is not known, they seem to result from inflammation due to injury of the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer leg.

These pains are a member of a group of injuries called “overuse injuries.” They occur most commonly in runners or aggressive walkers.

These irritations can cause pain in the front of the outer leg below the knee. The pain of shin splints is characteristically located on the outer edge of the mid region of the leg next to the shinbone (tibia).

An area of discomfort measuring 4-6 inches (10-15 cm) in length is frequently present. Pain is often noted at the early portion of the workout, then lessens, only to reappear near the end of the training session.

This discomfort is often described as dull at first. However, with continuing trauma, the pain can become so extreme, as to cause the athlete to stop workouts altogether.

A primary culprit causing this is a sudden increase in distance or intensity of a workout schedule. This increase in muscle work can be associated with inflammation of the lower leg muscles, those muscles used in lifting the foot (the motion during which the foot pivots toward the tibia).

Such a situation can be aggravated by a tendency to pronate the foot (roll it excessively inward onto the arch). Similarly, a tight Achilles tendon or weak ankle muscles are also often implicated in the development of this problem.

The diagnosis of is usually made during examination. It depends upon a careful review of the patient’s history, and a focused physical exam (on the examination of the shins and legs where local tenderness is noted).

Specialized (and costly) tests (for example, bone scans) are generally only necessary if the diagnosis is unclear. Radiology tests, such as X-rays, bone scan, or MRI scan, can be helpful in this setting to detect stress fracture of the tibia bone.

Previously, two different treatment management strategies were used: total rest, or a “run through it” approach. The total rest was often an unacceptable option to the athlete.

The run through it approach was even worse. It often led to worsening of the injury and of the symptoms.

Currently, a multifaceted approach of “relative rest” is successfully utilized to restore the athlete to a pain-free level of competition. The following steps are part of the multifaceted approach.

Workouts such as stationary bicycling or pool running: these will allow maintenance of cardiovascular fitness. Application of ice packs reduces inflammation.

Anti-inflammatory medications, such as ibuprofen (Advil/Motrin) and naproxen (Aleve/Naprosyn) are also a central part of rehabilitation. A 4-inch wide Ace bandage wrapped around the region also helps reduce discomfort.

Calf and anterior (front of) leg stretching and strengthening address the biomechanical problems discussed above and reduce pain. Pay careful attention to selecting the correct running shoe based upon the foot type (flexible pronator vs. rigid supinator).

This is extremely important. In selected cases, shoe inserts (orthotics) may be necessary.

Stretching and strengthening exercises are done twice a day. Run only when symptoms have generally resolved (often about two weeks) and with several restrictions.

A level and soft terrain is best. Distance is limited to 50% of that tolerated pre-injury.

Intensity (pace) is similarly cut by one-half. Over a three- to six-week period, a gradual increase in distance is allowed.

Only then can a gradual increase in pace be attempted. The extent of injury that occurs prior to any rehabilitation program plays a significant role in determining the time frame necessary for complete recovery.

If you are feeling this kind of pain, try doing some thorough stretching before you do any kind of exercise in the future, including using your treadmill. If the pain does not go away, you may want to seek the advice of a doctor.

Make sure you take as much stress as you can off of the affected area. Ice and stretching is really the best medicine in these cases.