Shin Splints

Shin splints is a painful condition caused by inflammation of the tendons and muscles of thetibia or shin bone. This condition is medically referred to as medial tibial stress syndrome or MTSS. Shin splints are caused by vigorous physical activities such as exercise or sports and is common in distance runners, athletes, and dancers. Pain in the inner part of the tibia, the large bone in the lower leg, may be shin splints and should be assessed by a physician to avoid further complications.

Signs and Symptoms

Often children with shin splints complain of dull, intense and persistent pain with mild swelling in the front side of the lower leg or along the shinbone. The pain may be felt only during exercise or may linger even after the activity. Sometimes, there is loss of sensation in the foot.

Causes

Shin splints are a common overuse injury resulting from repetitive vigorous sports training or from a sudden change in your physical activity level. Other causes of shin splints can include:

Stress fractures resulting in tiny, hairline cracks in the leg bone 

Tendonitis caused by a partial tear in the tendon

Chronic exertional compartment syndrome, an uncommon condition causing muscle swelling resulting in increased pressure within the muscle compartment. Pain is severe in this condition and can lead to permanent numbness or weakness if left untreated.

Risk Factors

A risk factor is condition that contributes to the development of a condition. The risk factors for shin splints include:

Flat feet or a rigid arch that increases the stress on the lower leg

A tight Achilles tendon and weak ankle muscles Use of improper or worn‐out foot wear while exercising or performing sports activities

Diagnosis

Your child’s doctor diagnoses the condition based on a detailed medical history and a thorough examination of the child’s leg. Some additional tests your doctor may advise include:

X‐rays and bone scan: These are helpful in detecting stress fractures of the tibia

Magnetic resonance imaging (MRI) scan: The scan helps to reveal tendonitis (tendon tear).

Treatment

Following the diagnosis, your doctor will decide the treatment option. Your doctor may recommend conservative treatment or surgical treatment based on the severity of your condition and the symptoms.

Conservative Treatment

The treatment for shin splints is primarily conservative and is begun with the RICE treatment consisting of rest, ice, compression, and elevation.

Rest: Your child should rest completely and avoid activity that causes pain for atleast 2‐4 weeks. This allows the damaged tissues to heal.

Ice: Apply ice wrapped in a towel to the affected area for no more than 20minutes at a time, several times a day.

Compression and elevation: An elastic compression bandage should be worn and the leg should be kept in an elevated position to help reduce swelling.

NSAIDs: Non-steroidal anti‐inflammatory drugs that are available over‐the‐counter can help reduce pain as well as swelling.

Flexibility exercises can be done to stretch the leg muscles. This eases pain, improves muscle strength and makes it less susceptible to injury.

Ensure your children wear proper shoes that provide good cushioning and support to the feet to reduce stress on the shin bone.

Surgical Treatment

Surgical treatment is considered only when conservative methods fail to relieve pain or in conditions of severe pain due to compartment syndrome. The goal of surgery is to relieve the pressure built up within the muscle compartment.

Fasciotomy surgery is performed in a hospital operating room under general anesthesia. The surgeon makes an incision on the side of the lower leg to access the fascia layer, the connective tissue covering the muscles and organs. This layer is cut away and removed to relieve the pressure within the compartment. The incision is closed with sutures and a surgical dressing is placed.

Risks and Complications

Complications are rare but can occur with any surgery. Fasciotomy complications may include the following:

Bleeding

Infection

Nerve damage

Numbness

Scarring

Bulging calf muscle when exercising

Prevention

You can prevent shin splints from occurring by following these measures:

Ensure use of shoes with good support which are suitable for the sports activity.

Make sure your child performs warm‐up exercises to stretch their leg muscles before starting any vigorous activity.

Instruct your child to avoid running on hard surfaces such as asphalt and concrete.

Avoid sudden increase in activities without proper warm up