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What are shin splints?

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This seems to be the most searched topic on google when it comes to running injuries so I figured I better address this on my blog!

What are shin splints?
Simply put, it is pain that occurs to the lower legs (shin area) that come arise from a number of different reasons. It’s a catch all term for leg pain. The pain can be due to several possible injury patterns that I will review below.

Medial Tibial Stress Syndrome (MTTS) is a condition where then deep tissue structures (specifically the deep fascia surrounding the muscles) become inflamed from stress of overuse. The theory is that it pulls on its attachment to the leg bone (tibia) causing pain.

Tibial Stress Fractures. A stress fracture can occur to the tibia (the long bone of the lower leg) and usually presents as pain that is pin point or in one specific area along the tibia. It typically hurts with walking as well during an entire run as opposed to resolving when you warm up. This is best diagnosed with an MRI.

Tendinitis. This is probably the most common cause of pain to the lower extremity that gets labeled “shin splints” by runners. Without going into an in depth anatomy lesson, think of the leg having compartments of muscles. Shin pain will usual effect the inside or medial compartment of muscles (specifically the deep posterior compartment). The posterior tibial tendon and muscle becomes overused and develops a tendonitis. Pain along the outside of the leg involves the lateral compartment and is due to overuse of the anterior tibial tendon.

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Compartment syndrome. This is a more serious condition where the muscles in the four compartments become engorged with blood due to increased activity and places pressure in the nerves in these compartments. Symptoms include severe pain followed by numbness and tingling during that activity that eventually requires the runner to stop. Within 30 minutes the symptoms usually resolve. This condition usually requires surgical release of the compartments however recent literature is now suggesting by altering your running form to a more natural form with a midfoot or forefoot strike pattern can resolve the condition.

What causes shin splints?
The most common cause of shin splints is from overuse which can be to due to running too much too soon, or going too fast too often. Improper form can also lead to shin splints as it places undue stress to the leg muscles causing them to become overused.

In my practice I approach these above conditions by correcting running form, training intensity, and training patterns. Rarely if ever does a runner need a shoe orthotic to correct these injuries.

As always, if you are experiencing any of these symptoms, it is best to contact your doctor and halt your running.

Thanks for reading!

-Dr. Nick

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