Shin pain (shin splints)
What is it?
This is pain down the shin bone (tibia) or along the inside of the lower leg. Shin splints is an inexact term that encompasses a few specific conditions causing shin pain. These include medial tibial stress syndrome, compartment syndrome and stress fracture.
Symptoms
Medial tibial stress syndrome causes pain and tenderness along the inside of the lower leg. Stress fractures can also occur in this area. Pain down the front of the shin is often due to a form of compartment syndrome or to stress fractures. Stress fracture of the tibia will give rise to dull pain over the shinbone and it will be tender to the touch. The pain will worsen during exercise. Symptoms of compartment syndrome are leg pain, strange nerve sensations such as tingling or pins and needles, and weakness.
Causes
Medial tibial stress syndrome results from damage to the connective tissue and muscles caused by repeated stress to the lower leg. This can be caused by overtraining or by abnormal pronation (rolling in of the foot), such as caused by running on the edge of a crowned road.
Anterior compartment syndrome occurs when the large muscle down the front of the shin — the tibialis anterior — swelling up during activity until it is too big for its sheath. This can be caused by overuse and overdevelopment of the muscle.
Stress fractures are overuse injuries that can occur in deconditioned people who undertake a new exercise program and don’t build up the intensity gradually. Stress fractures of the tibia are especially common in sports involving running and jumping.
Treatment
Medial tibial stress syndrome: Rest, ice and anti-inflammatory medicines are the mainstay of initial treatment, followed by rehabilitation exercises. If the person has foot or gait abnormalities, orthotics may be recommended.
Anterior compartment syndrome: Sometimes surgery is needed to decompress the muscle compartments. This can be a medical emergency in the case of acute (sudden) compartment syndrome when delays may result in irreversible tissue damage and loss of limb. Treatment of chronic (ongoing) compartment syndrome may involve modification of activities and training, and deep massage.
Stress fractures: Treatment usually involves rest, ice, and anti-inflammatory medicines.
Last Reviewed: 02 September 2009
- 1. The Merck Manuals Online Medical Library. The Merck Manual for Healthcare Professionals. Exercise and sports injury: shin splints [website]. Updated April 2009. Available from http://www.merck.com/mmpe/sec21/ch324/ch324l.html#CHDCDFGE (accessed Nov 2009).
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