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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Shin Splints

What is it?

Shin splints refer to pain in and around the large bone of the lower leg (tibia) due to exercise.While the exact cause is not known, shin splints appear to develop from excess stress or shock to the tibia and its surrounding tissues, such as occurs during running. The pain typically occurs on the inside portion of the leg. In severe cases, the tibia may gradually crack, forming a stress fracture. These injuries are common among joggers, dancers, or anyone whose exercise routine or occupation involves pounding of the feet on hard surfaces. In most cases a few weeks of rest followed by a regimen of proper conditioning will allow a safe return to a full complement of normal activities.

What Causes It?

  • Increased amount or intensity of exercise in legs not conditioned to the stress.
  • Inadequate training or improper technique.
  • Improper or worn-out footwear that no longer absorbs impact sufficiently.

Prevention

  • Be sure to stretch your calf muscles thoroughly in your regular warm-up before exercise.
  • Use proper athletic footwear with good cushion.
  • Run on grass or dirt paths instead of on concrete.
  • Avoid sudden increases in the intensity of your workout.

Diagnosis

  • Patient history and presentation of symptoms.
  • Examination of the foot and lower leg helps to establish any anatomical predisposition.
  • An x-ray or bone scan may be used to diagnose a hairline stress fracture when symptoms are prolonged or recurrent.

How to Treat It

  • Rest, usually for two or three weeks, is the most common recommendation and may be combined with physical therapy to strengthen any affected muscles.
  • A temporary switch to low-impact activities such as bicycling or swimming is advised if high-impact exercise (like aerobic dancing or running) appears to have caused shin splints.
  • Wear shoes that are well cushioned and provide good support.
  • For pain, take over-the-counter anti-inflammatory drugs such as aspirin or ibuprofen.
  • Ice packs may be recommended for swelling and inflammation.
  • Heat, in the form of whirlpool or hot soaks, may reduce discomfort.
  • Stretching exercises, particularly of the calf, and self-massage may ease pain.
  • A podiatrist or orthopedist may recommend an orthotic device (a specially fitted insert) to place in your shoes.Orthotics may help to correct structural anomalies that promote repeated episodes of shin splints.

When to Call a Doctor

  • If shin pain persists for more than three weeks despite self-treatment, consult your doctor. You may be referred to a podiatrist or orthopedist for further evaluation and treatment.