Other Names

Medial tibial stress syndrome

What are Shin Splints?

Shin splint is an injury to the medial aspect of the tibia (shin bone), resulting from overuse.

There are several muscles involved in any activity, relating to the feet, for example, running. The soleus muscle and the flexor digitorum longus are attached to the tibial bone. Over-activity of the muscles produces stretching and places stress on their attachment to the bones. These micro-injuries take time to heal. However if the activity is continued, ignoring the warning symptoms l the tendons get inflamed. The periosteum, which is connected to the tendon, also gets inflamed. This is an extremely painful condition and may lead to stress fractures if not taken care of.

Causes, Incidence and Risk Factors

The causes of shin splints are:

• Rigorous training periods that include running, aerobic dancing, etc.
• Running on hard surfaces like concrete
• Wearing worn-out shoes while training. Old shoes do not have sufficient shock-absorbing qualities.

The condition is typically more common in dancers, runners and military personnel.

There are certain co-existing deformities of the feet that increase the risk of developing shin splints, by increasing the stress on the tendons:

• Abnormal or rigid arch of the foot
• Flat foot

Signs and Symptoms

An individual suffering from shin splints usually complains of pain around the inside of the shin bone (tibia). The pain may start from anywhere above the ankle to the middle one third of the shin bone and extend over an area of 3 to 4 inches. The pain and tenderness is further aggravated with increased activity.

Screening and Diagnosis

Sufferers generally report a recent increase in activity level. A physical examination confirms pain and tenderness at the shin bone. Laboratory investigations such as blood tests are not required. Radiographic studies may be done to evaluate the condition and rule out stress fractures. MRI and Ultrasonographic studies are helpful in confirming the diagnosis.

Treatment

Conservative treatment methods are all that is needed to correct shin splits.

• Rest is a must, to help the tissue heal.
• Application of ice can soothe the inflamed muscle.
• Anti-inflammatory drugs are prescribed, to relieve pain and inflammation.
• The exercise regimen should be modified.
• Discard worn-out running shoes.
• Strengthening exercises for the calf muscles can help.
• Activities should be resumed only after recovery.

Prevention

• Training should not be done on hard surfaces.
• Low intensity activities should occasionally take the place of high intensity ones.
• Proper footwear should be worn for better shock-absorbing.