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Why do Shin Splints happen

Rafael Nadal shin splint injury
SHIN SPLINTS

Why do shin splints happen 

Shin splints happen cause of change in the lifestyle. That change could be sudden(accidental) or gradual(overuse).
Most often shin splints are result of rise in the physical activity which creates excessive pressure over bone tissues, precisely the shin bone (tibia) in case of shin splints. 
Shin splints aka MTSS (medial tibial stress syndrome) or Periostitis tibial is inflammation in periostium(outermost layer) of shin bone.

Mechanism behind Pain of Shin Splints

The pain is caused by disruption of connective tissue which connects the medial soleus fascia(tissue covering muscle) through the periosteum(outermost layer of bone) of the tibia. With repetitive stress, the impact of forces eccentrically fatigue the soleus(leg muscle significant for running) and create repeated tibial(major bone in lower leg) bending or bowing, leading to Shin Splints. This is the answer to " why do shin splints happen ".

What are shin splints caused by

Except overuse various other reason may cause shin splints such as:
  • Flat feet  
  • High arches
  • Wearing wrong shoe while running 
  • Previous Ankle or Knee injury
  • Trauma due to accident
  • Being overweight
  • Improper way of Workout/Gym 
  • Excess uphill or downhill activity
  • Weak calf muscles
  • Unequal leg length

Who is at risk of having shin splints

Professionals like Athlete, Defence Personnel, Dancer commonly have shin splints.
  • Women are more prone due to hormonal changes affecting bone health. 
  • Old aged people.
  • Obese people
  • Malnutrition i.e. those who do not eat adequate amount of minerals, vitamins, Micro-Nutrients.

Pain site of shin splints
Pain site of Shin Splints

Diagnosis of shin splints 

One can even self diagnose shin splints.
The pain is mostly present over a particular region of shin bone i.e. inner side(postero medial of tibia) of lower leg and is spread over 5 cm in length(lower 2/3rd region).
  • Shin pain is dull in nature.
  • Pain rises with activity whereas subsides during rest.
  • Shin Pain can be felt on palpating the affected region(tenderness).
  • Presence of swelling(edema) over the shin bone can be felt.

Doctor's advice for Shin Pain

Doctor will take relevent history: enquire about recent changes in activity level or about previous injuries.
Doc will ask about cramps, burning or pins and needles like sensation in the foot (these could be sign of CECS)
He will do physical examination to look for the area of pain and its severity.
He will rule out the possibility of other complications such as:
Stress Fracture, Chronic Exertional Compartmental Syndrome (CECS), Deep Vein Thrombosis (DVT), Popliteal Artery Entrapment, Muscle Strain Tumour, Arterial endofibrosis, Infection Nerve entrapment.

Imaging tests to diagnose shin-splints

Most often these tests aren't required but must be done in those cases where other condition is suspected.

Shin splints mri image
Bright region- injury over shin bone

MRI
It's very sensitive radiological examination. MRI findings will range from normal to periosteal fluid and marrow edema in shin splints to a complete stress fracture.

CT
It may reveal mild osteopenia as an early sign of damaged cortical bone in shin splints.

Ultrasound
Shows focal hyperechoic elevation of the periosteum with irregularity over the distal tibia and increased flow on Doppler studies. 

X Ray
Insignificant test but If the injury has evolved into a stress fracture, an x-ray scan can show black lines.

Now the most relevent question: How do you heal shin splints?

Shin Splints heal by themselves, but you can take measures to hasten the healing process.
  • Provide proper Rest to the legs.
  • Elevate the affected leg while resting.
  • Apply Ice over the painful region.
  • Use Compression Socks or Braces.
  • Wear Proper Shoes with cushions.
  • May take meds for pain relief.
  • Perform Stretches to release stress over shin bone and surrounding tissue.
  • Very soon you will recover from Shin Splints.
Surgical treatment is indicated to the patients, who have recurrent shin pain for atleast a year even after conservative treatment.The objective of surgery is to release tension in deep posterior fascia of tibia, to pave the way for proper circulation of tissues.

Compression socks to help shin splints
Compression Sock 

FAQ'S on Shin Splints 
Should you massage shin splints?
Yes

Does it hurt to touch shin splints?
Yes

Do compression socks help with shin splints?
Yes 

How should I sleep with shin splints?
Legs in elevated position(pillow beneath legs).

Do your shins get stronger after shin splints?
Yes

How do you get rid of shin splints without stopping running?
You will have to take rest for few days atleast.

How do you get rid of shin splints overnight?
No such way but shin pain can be treated with pain killers.

How long will shin splints last?
Depends on the severity of injury.

Prevention of shin splint?
Must do stretches and warm up and take proper rest for recovery.

Conclusion: Shin Splints are very common with physically active people. Shin pain should not be ignored rather dealt with patience and care.


Comment us about your own experiences on injuries. Your comeback story will be featured on this blog in a special section.
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