Shin splints, a common ailment among athletes and active individuals, refers to the pain and discomfort experienced along the shinbone (tibia). This condition, medically known as Medial Tibial Stress Syndrome, often affects those who engage in vigorous physical activities, particularly running and jumping sports.
Pushing through and trying to ignore the pain caused by medial tibial stress syndrome (MTSS) can have harmful consequences as it risks increasing the severity of the condition, prolonging recovery time and potentially leading to being out of action for the rest of the sporting season.
To avoid extended time off sport and minimising the chance of more serious injury it is important to be assessed by a Physiotherapist so that your injury can be accurately diagnosed and treated appropriately to safely guide your recovery back to sport. This article will explore the common causes, symptoms, and treatment options for shin splints — providing insights into how to manage this condition for a pain-free experience.
Shin Splints: What Are They?
‘Shin splints’ is an umbrella term used to describe pain over the large bone (tibia) in the lower leg. Typically pain presents on the medial side of the tibia and in the middle-lower third. However, pain may also be present along the entirety of the shin bone from the ankle to the knee.
Shin splints typically develop from repetitive stress which can cause inflammation of where muscles attach to the tibia or trauma to the outer layer of the bone. After long periods of high load, or a sudden increase in load, these structures may not be given enough time to recover (1).
Possible Causes
It is most common in athletes who play in high impact sports such as running, basketball, soccer and netball. Other factors contributing to MTSS include overuse, inadequate footwear, low quality or amount of recovery between training, and running on hard surfaces.
Stress Fractures
Medial tibial stress syndrome can lead to fractures if the stress on the shinbone continues without proper rest and treatment. Understanding the progression from MTSS to stress fractures is crucial for timely intervention and prevention of more severe injuries.
Each time we exercise, our bones are placed under strain and suffer a degree of breakdown. (2) Usually, our bodies are able to balance out this breakdown by repairing and remodelling the structure resulting in the maintenance of a healthy bone. When this balance is offset by placing continued strain on the bone, the breakdown of tissue occurs at a rate greater than our body’s repair process.
In summary, this process occurs along a continuum that begins with a stress reaction, which can progress to a stress fracture as damage to the bone continues to accumulate which can then ultimately lead to a complete bone fracture.
How is a diagnosis made for injury to the bone?
Diagnosing a bone injury, such as a stress fracture resulting from splints, typically involves a combination of patient history, physical examination, and imaging. Imaging may initially involve an X-ray, although it might not always detect early MTSS or stress reactions.
An MRI or bone scan is most effective in identifying subtle changes in the bone and can confirm a diagnosis of medial tibial stress syndrome or a stress fracture. Early diagnosis is key to preventing further damage and starting appropriate treatment. (3)
Symptoms
Initially the pain usually begins as a dull ache and can ease with rest and reduced activity. However, if left unmanaged, can progress to sharp pain which persists for long periods of time after ceasing activity. This may cause a stress fracture of the tibia which has an increased time for recovery.
They are particularly common in athletes involved in running and jumping sports, but can also occur in individuals who have recently intensified or changed their workout routines. Accurate clinical assessment is vital for distinguishing MTSS from other conditions. (4)
Spotting Shin Splints: Risk Factors
Understanding the risk factors is essential in both prevention and early detection. This condition is not limited to athletes; anyone who suddenly increases their physical activity level could be at risk.
Key risk factors include:
- Sudden increases or spikes in training intensity and duration
- Failure to adequately rest in between training sessions
- Flat feet and arches
- Tight or weak calves
- Poor running technique
- Inappropriate footwear
- Running on concrete or uneven surfaces
When Should I See a Doctor?
Consulting a professional when experiencing symptoms of medial tibial stress syndrome is crucial for a multitude of reasons. Firstly, a healthcare professional is equipped to accurately diagnose the cause of your pain. It’s important to determine whether the discomfort is indeed due to shin splints or another condition.
Moreover, professionals are adept at crafting personalized treatment plans that are specifically tailored to the severity and particularities of your condition. This approach ensures that the treatment you receive is most effective for your unique situation.
If you think you might be currently suffering from MTSS don’t keep trying to ignore and push through the pain. Take care of yourself and book in to see one of the physiotherapists here at Coast Sport to help guide and support you through your recovery back to sport.
Treatments
The treatment involves a multifaceted approach, focusing on relieving pain, reducing inflammation, and addressing the underlying causes. This can range from rest and ice to more specific physical therapy techniques. The goal is to allow the tibia and associated muscles and tendons to heal and to prevent the recurrence of the injury.
Nonsurgical Treatment
When it comes to managing shin splints, non-surgical treatments are the primary approach. Effective treatments include:
Rest
Allowing time for the affected muscles and bones to heal is crucial.
Ice
Applying ice to the shin can help reduce pain and inflammation.
Compression
Apply compression to reduce swelling and support the affected muscles and tendons.
Nonsteroidal Anti-inflammatory Drugs
Discuss with your doctor or pharmacist about over-the-counter pain relievers that can be used to alleviate discomfort. (5)
Strength and Mobility Exercises
A physiotherapist can recommend exercises to strengthen the lower leg muscles and improve flexibility.
Taping
Different taping methods can be trialled to provide relief
Orthotics or supportive shoes
Reduce the strain on the shins by providing additional cushioning and support.
Return to Exercise
De-loading is essential to allow for bone healing. Once improvements have occurred, gradual and structured return to training and competition would be managed by your physiotherapist.
In more severe cases, or if the pain persists, your physiotherapist may refer you to a sports doctor or other allied health professional to address other factors which may impact your recovery.
Prevention Methods
The best approach to managing MTSS is to prevent them from occurring. This involves understanding your body’s limits, gradually building up exercise intensity, and paying attention to pain signals. Prevention tips include:
- Gradual Increase in Exercise Intensity: Avoid sudden spikes in workout intensity or duration. Gradually increase your exercise load to give your body time to adapt.
- Proper Warm-Up and Cool-Down Routines: Engaging in proper warm-up exercises before and cool-down exercises after physical activities can help prepare your muscles and reduce the risk of injury.
- Appropriate Footwear: Wear shoes that are suited to your activity and provide adequate support and cushioning. Replace them regularly to ensure they maintain their supportive properties.
- Cross-Training: Incorporate low-impact activities like swimming or cycling into your routine to give your shins a break from high-impact stresses.
- Strength and mobility Exercises: Regularly perform exercises to strengthen the muscles of the lower leg and improve overall flexibility.’
By incorporating these preventative strategies into your routine, you can significantly reduce the risk of developing shin splints, ensuring a more enjoyable and sustainable exercise regimen. (6)
What Happens if Shin Splints Are Not Properly Treated?
Untreated shin splints can result in long-term damage to the muscles and tendons, leading to persistent discomfort and limiting an individual’s ability to participate in physical activities.
It’s crucial to address shin splints early on, with proper diagnosis and a tailored treatment plan, to prevent these potentially debilitating outcomes and ensure a quicker return to pain-free movement.
Failing to treat shin splints properly can lead to more severe complications, including stress fractures and chronic pain. Without adequate rest and appropriate treatment, the continuous stress on the shinbone can cause small cracks or fractures, which require a longer recovery period and more intensive interventions.
If you are suffering from shin splints or pain in your shins, come see one of our expert physiotherapists. Book a consultation today to start easing your pain.
References
- Healthdirect Australia. Healthdirect.gov.au
- Cleveland Clinic” Cleveland Clinic
- Mayo Clinic. Diagnosis and Treatment.” Mayo Clinic
- American Academy of Orthopaedic Surgeons. “Symptoms.” OrthoInfo
- Mayo Clinic. “Treatment.” Mayo Clinic
- American Academy of Orthopaedic Surgeons.”Prevention.” OrthoInfo
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