About Chronic Shin Splints

Overview

Chronic shin splints, also known as chronic medial tibial stress syndrome, refers to a long-lasting or recurring condition characterized by persistent pain along the inner side of the shinbone. It happens due to repeated stress on the muscles, tendons, and bone in the lower leg, often from overuse or too much activity without enough rest. Chronic shin splints typically develop when there is not enough time for proper healing between episodes of activity. The pain experienced with chronic shin splints may be dull or sharp and can occur before, during, or after exercise. It is important to seek medical attention for chronic shin splints to determine the underlying cause and develop an appropriate treatment plan.

Causes and Risk Factors

Chronic shin splints can be caused by several factors, including:

Disease mechanism and causes:

• Excessive force on the shin bone and surrounding tissues, leading to swelling and inflammation.
• Stress reactions to bone fractures, resulting in tiny cracks in the leg bones.

Unchangeable risk factors:

• Abnormal body structures, such as having flat feet or rigid arches.
• Certain occupations or activities that involve high impact on the legs, like military training or dancing.

Changeable or controllable risk factors:

• Muscle weakness in the thighs or buttocks.
• Lack of flexibility.
• Improper training techniques.
• Running downhill or on hard surfaces like concrete.
• Using inappropriate or worn-out shoes.
• Participating in sports with sudden stops and starts, such as sprinting or tennis.

It's important to note that these risk factors can increase the likelihood of developing shin splints, but they don't guarantee their occurrence. To reduce the risk of chronic shin splints, it's advisable to address modifiable risk factors through appropriate training techniques, proper footwear, and maintaining overall muscle strength and flexibility.

Symptoms

The most common early symptoms of chronic shin splints include:

• Pain and tenderness along the tibia (shin bone).
• Start of swelling of the lower legs.
• In severe cases, there may be red patches on the skin around painful areas.

As chronic shin splints progress or become more severe, additional symptoms may occur, such as:

• Lumps or bumps felt along the bones.
• Constant pain that persists even after exercise.
• Increased sensitivity to touch in the affected area.

It's important to note that these symptoms can vary from person to person. If you are experiencing any of these symptoms, it is recommended to have them checked by a doctor. They can help diagnose shin splints and rule out other conditions with similar symptoms.

Diagnosis

To diagnose chronic shin splints, doctors commonly perform the following examinations, tests, and procedures:

• Medical history: Your doctor will ask about your physical activities, including sports and exercise routines.
• Physical examination: Your doctor will examine your shins for pain and tenderness. They will also check if the pain is located in the leg muscle or tendon rather than the shinbone itself.
• Imaging scans: If there is suspicion of bone fractures or another condition causing the symptoms, your doctor may prescribe imaging scans such as X-rays, magnetic resonance imaging (MRI), or bone scans.

To determine the stage or severity of chronic shin splints, additional examinations, tests, and procedures may include:

• Assessment of pain timing: Your doctor will ask about the timing of your pain in relation to your training sessions and whether the pain continues when you are at rest
• Evaluation for other conditions: Your doctor may rule out other potential causes of pain that mimic the symptoms of shin splints, such as stress fractures, tendinitis, compartment syndrome, or nerve problems

Remember, these are general guidelines and each individual's diagnosis and severity may vary. Consult with your healthcare professional for personalized advice.

Treatment Options

The goals of treatment for chronic shin splints are to relieve pain and enable the patient to return to normal activities without pain. Here are the recommended treatments and how they work to achieve these goals:

• Rest and Recovery: Resting and avoiding activities that cause repetitive stress on the shins helps reduce pain and inflammation, allowing the body to heal.
• Physical Therapy: A professional therapist can provide exercises to stretch and strengthen calf and ankle muscles, as well as correct any muscle or mechanical abnormalities contributing to shin splints. Physical therapy aims to improve muscle strength and flexibility, reducing strain on the shins.
• Shock Wave Therapy: This involves applying low-energy shock waves to the shins, which can be effective in treating chronic shin splints. It helps stimulate healing and shortens the recovery time.
• Home Remedies: Simple home remedies include rest, ice packs to reduce inflammation, over-the-counter medications like ibuprofen for pain relief, gentle stretching of the Achilles tendon, and gradually resuming exercise after pain subsides.

Medication type and dosing are affected by many factors and may vary by individual, and additional side effects may occur. Consult your healthcare provider for personalized advice and read the information provided with your medication.