Monday, February 9, 2009

Shin Splints


Shin Splints most often are correctly named Medial Tibial Stress Syndrome and occasionally Posterior Tibial Tendinitis. In our clinic, we typically see Medial Tibial Stress Syndrome in active runners and soccer players. The beginning of cross country season and the beginning of track season are the times we typically see this complaint.

Usually, the onset correlates to early training with overuse occurring such that there is shin pain associated with running. Deconditioned people who start training, active people who increase their mileage, lengthen their stride, or start doing jumping drills, or runners who start running further on hard surfaces or down hills are all susceptible to MTTS. The worry is that the leg pain might be a stress fracture or even a compartment syndrome.

Typically, the pain associated with compartment syndrome is early onset and lasting, and seems out of proportion to the amount of effort expended. Compartment syndrome is ultimately diagnosed with Doppler technology, and if you think you have shin splints that do not seem to get better at all ever, then it might be that you have a compartment syndrome and you should get that checked out. The other concern, stress fracture, can usually be ruled out by trying to hop on the injured leg. If you cannot do so, and the pain persists, then you might indeed have a stress fracture. in the case of MTSS, the pain usually resolves quickly after activity.

The best treatment for MTSS is to stop running for a time, PLUS perform ice massage along the injured area, PLUS improve your shoes, PLUS modify the surfaces you are runing on, PLUS use tape or a shin strap when you do return to running.

One good exercise to help you is to sit in a chair with your elbows on your thighs, and while keeping your heels on the floor, rapidly tap your feet one after the other until you are too tired to do more. Allow a time to recover, and repeat.

Return to running gradually and perferably on flat softer surfaces with new shoes. Build your mielage gradually, improve your speed gradually and you will likely overcome this ailment without difficulty.