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Shin Splints -Periostitis

What are shin splints? The term shin splints is a name often given to any pain at the front of the lower leg.  However, true shin splints symptoms occur at the front inside of the shin bone and can cause pain from a number of reasons.  The most common cause is inflammation of the periosteum of the tibia (sheath surrounding the bone).  Forces on the periosteum from the muscles of the lower leg cause shin pain and inflammation.

Symptoms of shin splints include:

• Pain over the inside lower half of the shin.
• Pain at the start of exercise which often eases as the session continues
• Pain often returns after activity and may be at its worse the next morning.
• Sometimes some swelling.
• Lumps and bumps may be felt when feeling the inside of the shin bone.
• Pain when the toes or foot are bent downwards.
• A redness over the inside of the shin (not always present).

Treatment of shin splints is as simple as reducing pain and inflammation,as well as  identifying training and biomechanical problems which may have helped cause the injury initially, and building muscles to their original condition and gradually returning to training.

Causes of shin splints

Shin splints can be caused by a number of factors which are mainly biomechanical (abnormal movement patterns) and errors in training. Here are the most common causes:

• overpronation of  the feet
• oversupination of the feet
• Inadequate footwear
• Increasing training too quickly
• Running on hard surfaces
• Decreased flexibility at the ankle joint

What can the athlete do about shin splints?

• Rest to allow the injury to heal.
• Apply ice in the early stages, particularly when it is very painful. Ice will reduce pain and inflammation.
• Stretch the muscles of the lower leg. In particular the tibialis posterior which is associated with shin splints.
• Wear shock absorbing insoles in shoes. This helps reduce the shock on the lower leg.
• Maintain fitness with other non weight-bearing exercises such as swimming, cycling or running in water.
• Apply heat and use a heat retainer or shin and calf support after the initial acute stage and particularly before training.  It will  retain the natural heat which causes blood vessels to dilate and increases the flow of blood to the tissues to aid healing.
• Visit a sports injury clinic or physical therapist for treatment and rehab
• Operate (this is rare).

Prevention

In order to prevent them from reoccurring several factors must be taken into consideration.  If  the athlete doesn't correct the cause of the injury the symptoms and injury will return later.  Biomechanical problems such as overpronation and supination can be corrected by using proper shoes specially designed for the problems.  Not increasing your running mileage to fast will help prevent this injury.  The standard rule is not to increase your mileage by more than 10% over a week.  This will help to ensure the muscles are not overworked to quickly.  You should try to avoid running on hard surfaces all the time try to run on trail every once in a while .  This will help reduce the shock put your legs.  Shin splints can be caused by overly tight muscles in the lower leg including the gastrocneminus and soleus (back of the leg) and the shin muscles.  Stretching  these muscles daily will help strengthen the muscles.