Shin splints is a general term used to describe pain in the front of the shin or tibia bone. This pain can be caused by damage (tiny cracks) to the tibia bone itself, tears in the tibialis anterior muscle, or tears along the tibialis anterior tendon where it attaches to the tibia. It is also referred to as Anterior Compartment Syndrome or Medial Tibial Stress Syndrome, depending on the location of the pain. This condition is often caused by stress to the tibia and surrounding muscles due to an increase in athletic training or demanding training programs (i.e. marathon runners).
Although "shin splints" usually refers to pain that occurs at the outer, front part of the lower leg (anterolateral shin splints), it less commonly refers to pain at the back, inside of the lower leg (called posteromedial shin splints). Both types are painful, with pain occurring anywhere from just below the knee all the way to the ankle, and can take a long time to heal without proper treatment.
The most common cause of shin splints is continued, repeated stress to the tibialis anterior muscle and tendon, the extensor digitorum longus muscle, the extensor hallucis longus, the tibialis posterior muscle and tendon, and the soleus muscle as well as the tissue around the muscles (deep crural fascia) attached to the tibia. Excess wear and stretching of these tendons and muscles can occur with repeated stress or jarring of the tibial bone. In addition, when the muscles swell they put pressure on the fascia which causes more pain. Without an appropriate amount of recovery time or proper conditioning these muscles, the deep crural fascia, and the tibial tendons can become stressed and/or torn to the point of inflammation.
Due to the cause, shin splints are considered a repetitive or cumulative stress injury and are common among runners, gymnasts, dancers and other sports that involve high impact on the foot and lower leg. Approximately 10-15% of all running injuries are attributed to shin splints.
Anterolateral shin splints affect the tibialis anterior muscle in the outer, front portion of the lower leg. This condition can be the result of a natural imbalance in the size of opposing muscles. Shin muscles pull the foot up, whereas the large and powerful gastrocnemius muscles in the calf pull the foot down when the heel strikes the ground. An imbalance can cause the heel to hit the ground improperly causing excess jarring of the tibia and surrounding muscles.
Anterolateral shin splints will cause pain in the front and outside of the shin which can result from damage to the tibialis anterior muscle itself or the deep crural fascia. Initial pain is felt when the heel strikes the ground though eventually the pain just remains.
To allow this type of shin splint to heal, you should avoid activities that cause stress to the tibia and tibialis anterior muscles and do other kinds of exercise recommended by your doctor or PT. Such exercises usually involve stretching the calf muscle, as tight calf muscles put a lot of pressure on the shin muscle and the anterior tibial tendon.
Posteromedial shin splints affect the soleus muscle and the tibialis posterior muscles and pain appears in the interior (or medial bone) in the lower leg). These muscle groups are responsible for lifting the heel to support a runner's weight on the ball portion of the foot when running.
Posteromedial shin splints (also called Medial Tibial Stress Syndrome or MTSS) are often caused by running on a sloped track or other non-level running surface or wearing improper shoes that do not protect the foot from rolling (pronation).
Pain begins on the inside, back of the lower leg (usually within 7 inches above the ankles), but will worsen and continue to rise up the leg. Initially, only tendons will become inflamed, but if running continues, the muscles themselves could become affected. In the most severe cases, the tibialis posterior tendon could become detached from the bone - a painful occurrence that causes bleeding and excessive inflammation.
To allow a posteromedial shin splint to heal, the running must temporarily stop and other therapeutic exercises recommended by your doctor or PT can be done. Special shoes may be prescribed during the healing phase, and it may be advisable to look into potential problems with over-pronation of the feet (flat feet). This can often be solved by wearing shoes that prevent pronation and/or avoid running on side slopes.
Stress fractures (or bone trauma) in the tibia and fibula are sometimes related to anterolateral shin splints. Due to excess jarring of the bone, microscopic cracks may form in one or both of the lower leg bones. Avoiding the activity or sport that caused the cracks is advised to allow the bones to rest and repair. Without allowing enough time to recover, these cracks can become a fracture which is very painful.
Shin splints may be caused by:
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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition.
Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before using any of our outstanding products to make sure they're right for you and your condition or if you have any questions regarding a medical condition. Always see your doctor for a proper diagnosis as there are often many injuries and conditions (some very serious) that could be the cause of your pain.
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