Patient Education

Shin Splints

Description

If you’re like most other people, you may, on occasion, get kind of stressed out. And you probably have a good reason for it. Your boss might give you a fifty-hour-long project he wants done by the weekend. Or maybe your dog found that roll of hundred dollar bills you had stashed under the mattress, and decided it was the most delicious chew toy ever. Or your teenager went out for ice cream with friends and came back with a two- hundred dollar ticket and a car needing about a thousand dollars worth of repairs.

And, if you are like most other people, this stress might make you, well, wig out a little. You might start with grinding your teeth, and then move steadily on to pulling your hair, banging your fist on tables (and the occasional head), shouting for mercy from the skies, and, if things get bad enough, throwing off your clothes in a public water fountain.

Now your legs are a little more mild mannered than that (most of the time). For instance, instead of throwing a British bulldog into the punchbowl at the office party, your legs, when stressed, may develop shin splints. Now, we’re talking about a certain kind of stress here, usually caused by running or standing on hard surfaces or up or down inclines, being overweight, having flat feet, wearing worn out shoes, participating in sports with a lot of stopping and starting (like basketball), and not properly training for vigorous activities. In short, we’re talking about stressing out the muscles that attach to your shinbone (tibia) or the thin tissue that covers the bone. Both the muscles at the front of the lower leg and the back of the leg can be involved in shin splints. These muscles and tissues can become inflamed when stressed, which means you’ll be kind of uncomfortable until you can get your legs to calm down again.

Compartment syndrome, a very serious condition in which swelling of tissues causes a lack of bloodflow to a part of the body, can also cause pain in the shin, and can sometimes be confused with shin splints. Or stress fractures could be the culprit. So, if your pain is consistent or severe, or if you notice that your leg looks pale, weak, or has any loss of feeling, you definitely want to get it checked out by a doctor.

Symptoms

Shin splints are characterized by feeling sore along the inside front of your lower leg (although any discomfort in the lower leg might be called shin splints). This pain may go away as you stop activity (at least at first), although as your muscles keep getting stressed out, they may start being painful pretty much all the time. Your leg may also swell a bit.

If you notice that the swelling gets worse, or if the pain is associated with a fall or other traumatic event, or is persistent and doesn’t improve with home treatment, it’s a good idea to see your podiatrist, who can evaluate your condition and get you the best treatment possible.

Diagnosis

Podiatrists aren’t necessarily nosy folks (and they certainly don’t want to cause you any more stress than you might already be experiencing), but in order to diagnose your condition properly, your friendly foot doctor will probably need to ask you a few questions about your pain. These will probably include how long you’ve been experiencing symptoms, how severe they are, whether they’ve gotten worse, where you’re experiencing pain, and what you may have done to treat the pain so far.

Aside from this medical history, your doctor may also want to perform a physical exam of your lower leg, and may suggest X-rays or other imaging studies to rule out other possible causes of your pain, such as a stress fracture.

Treatment

Chances are you’ll probably start treating your shin splints at home, although (depending on the ultimate cause of your pain) your podiatrist will also probably recommend some relatively easy treatments to ease your symptoms. These are likely to include the RICE method:

  • Rest – First of all, if your shins are hurting, give them a break. Don’t be the mean boss/bad dog/rotten teen to your shins. Stop the activity that’s causing them grief and switch to an activity that’s less stressful, such as swimming, walking or riding a bike (unless you’re riding a bike in heavy traffic, that is). Stay off your legs as much as you can while they heal.
  • Ice – In order to reduce swelling and ease pain, you can apply an ice pack on your leg for 20 minutes at a time between four and eight times per day (with at least a 40 minute break in between applications) and do this for a few days if you need to. By the way, you’ll want to wrap the pack in a thin towel so you don’t give yourself frostbite.
  • Compression – Wrapping your leg snugly with an elastic bandage could be helpful, although you’ll want to loosen the bandage if the pain gets worse or if you notice swelling below the bandage.
  • Elevation – Keep your leg raised up above heart-level as much as you can, and most definitely while you’re asleep. This reduces the amount of blood hanging around the area, which means your swelling (and pain) should go down.

A couple of other things should also help, including over-the-counter pain medication like ibuprofen (an anti-inflammatory), acetaminophen or aspirin. You can also reduce the amount of stress your leg muscles experience during activity by wearing decent shoes (just in case you’re wondering, this does not include the pair you’ve owned since you were a freshman in college 20 years ago), and possibly getting arch supports or orthotics (prescription shoe inserts). It’s also probably a good idea to increase your activity levels gradually, try cross training, and do toe raises to strengthen your muscles.

So, you may still have to shell out a bit of money for your teenager’s accident, pry bits of Ben Franklin’s portrait from the jaws of your German shepherd, or pull a couple of all-nighters to get that project done on time, but at least your legs can be calm, happy, and blissfully stress- free.