Shin Splints: Causes, Symptoms and Treatment

Shin splint is a condition in which pain is felt along the inner border of tibia, below the knee till the ankle. This condition may also refer to as medial tibial stress syndrome (MTSS). Repeated stress and weight on lower leg result in loss of naturally repair and restore of muscles, bones, and joints by itself causing inflammation around the tibia.

           Shin splint occurs mainly in athletes, runners, tennis players, even dancers. It frequently affects people who participate in excessive physical activity or an improper exercise program with a sudden change in intensity or frequency of training routine where they do not build their mileage gradually enough or who abruptly change their workout regimen such as suddenly switching from running on flat surfaces to hills. 

The pain can be the dull or sharp type which generally relieves by stopping the activity or during the rest period. Sometimes the pain gets so severe

 that you have to stop performing an exercise or else get worse by ignoring and continuing the activity.

CAUSES OF SHIN SPLINTS:

• The common cause for shin split is running, especially on hills.
• If a training technique is improper, or if an intensity, frequency or distance has increased all of a sudden.
• An exercise or a sport that has sudden activities of start and stop without much gap of break interval such as dancing, basketball or military training.
• Working out on hard or uneven surfaces while running during regimen
• Inappropriate shoes that don’t fit well or does not provide good support.
• No proper warm-up before workout or cooldown stretches after the workout.
• Sometimes, stress reaction from fracture of bone can also lead to shin splint.

RISK FACTORS OF SHIN SPLINT:

Various physical activity and improper body mechanics can put at risk of getting shin splint. Such as

• Flat feet- cause more stress on the lower leg during exercises.
• Over pronated foot – mostly causes medial shin splint
• The weakness of muscles of the lower leg
• Muscle tightness or less flexibility causes more pain
• Overweight- causes more weight on legs
• Recurrence is more common in a person who had the previous history of a shin splint.

SYMPTOMS:

• Dull or sharp throbbing type of pain along the inner side of the shin.
• Minimum swelling can also be seen in the pain area.
• Initially, the pain gets relieved once the exercises get the stop. Later, it will be continuous both during and after the exercise.
• Symptoms get aggravated by touching the spot
• Weakness in the foot muscles.

PHYSIO THERAPEUTIC APPROACH:

• Stop and take rest from the exercise or activity for 2 to 4 weeks which causing the pain.
• Icing the tender area for 5-10 minutes, 1-3 times a day will reduce the swelling.
• An elastic compression bandage around the painful part will reduce pain and prevents swelling.
• Stretch the tightened muscle of tibia and foot.
• Applying the tape to support the arch of the foot.
• Strengthening the weak musculature of the leg.
• Mobility exercises of the leg to reduce the over-pronation or flattening the arch of the foot
• Single-leg strengthening exercises including squats, reaching activities or heel raise.
• Modifying landing techniques on uneven surfaces should be taught1
• During walking and running, leg and foot control should be modified.
• Foam roller exercise can be done to massage over painful points.

 Prevention:

Shin splint can be prevented with the following measures:

• Reduce weight.
• The barefoot walk is also helpful to reduce the level of pressure on the bone.
• Proper footwear or supportive shoes should be used to support the leg during walking or exercising.
• Uses of orthotics or shoe inserts are helpful for foot abnormalities to align and stabilize the foot and ankle.
• Proper warm-up and stretch should be done before starting the workout.
• Once the pain reduces, exercise should be progressed slowly by increasing the duration, intensity, and frequency of exercise regimen.
• Activities such as cross terrain should be started from lower impact sports like alternating jogging, swimming or cycling to high impact exercises like running.