Shin Splints Shin splints (medial tibial stress syndrome pain) occurs along the inner edge of the shinbone (tibia) in the lower leg. It results from repeated stress and trauma to the to the connective muscle tissue surrounding the tibia on your shinbone causing the shinbone to become inflamed and painful.The most common area for shin splints is the medial area on the inside of the shin. Anterior shin splints which develop toward the outside of the leg usually result from an imbalance between the calf muscles and the muscles in the front of your leg, and often afflict beginners who either have not yet adjusted to the stresses of running or have not stretching enough. A sudden increase in intensity or frequency in running fatigues muscles too quickly to properly help absorb shock forcing the tibia to absorb most of that shock. This stress is associated with the onset of shin splints. Common Causes of Shin Splints Overpronation is a frequent cause of medial shin splints. Inadequate stretching and worn running shoes. Excessive stress placed on one leg or one hip from running on cambered roads or always running in the same direction on a track. Typically one leg is involved and it is almost always the runner’s dominant one. If you’re right handed you’re usually right footed as well and that’s the leg that’s going to hurt. Beginner runners who do not build their mileage gradually or experienced runners who abruptly change their workout regimen. suddenly switching from running on flat surfaces to hills or adding too much mileage. Signs and Symptoms of shin splints ? A dull ache to an intense pain that increases during exercise. ? Biomechanically over pronation is a common factor in shin splints and action should be taken to improve the biomechanics of the gait. ? Muscle imbalance, including weak core muscles, inflexibility and tightness of lower leg muscles can increase the possibility of shin splints. ? The impact is made worse by running uphill, downhill and on uneven terrain, or on hard surfaces. ? Improper footwear including worn out runners. ? Shin splints are also at their most painful when you forcibly try to lift your foot up at the ankle and flex your foot. Shin pain doesn’t always mean you have shin splints. It might be a sign of some other problem. It is important to differentiate between different lower leg pain injuries, including shin splints, stress fractures, compartment syndrome, nerve entrapment, and popliteal artery entrapment syndrome. These conditions often have many overlapping symptoms which makes a final diagnosis difficult, and correct diagnosis is needed to determine the most appropriate treatment. The pain of shin splints is also more generalized than that of a stress fracture. Press your fingertips along your shin, and if you can find a definite spot of sharp pain it’s a sign of a stress fracture. Additionally, stress fractures often feel better in the morning because the bone has rested all night while shin splints often feel worse in the morning because the soft tissue tightens overnight. Treatment of Shin Splints When shin splints strike you should stop running completely or reduce your training depending on the severity and duration of pain. ? A first step should be to ice your shin to reduce inflammation. ? If you have medial shin splints you should gently stretch your achilles and stretch your calves if you have anterior shin splints. ? If you decide to continue running use either tape or an ace bandage starting just above the ankle and continuing to just below the knee. Keep wrapping your leg until the pain goes away, which usually takes three to six weeks. This procedure binds the tendons up against the shaft of the shin to prevent stress. ? Consider cross training for a while to let your shin heal. Swim, run in the pool or ride a bike. ? When you return to running, increase your mileage slowly, no more than 10 percent weekly. ? Make sure you wear the correct running shoes for your foot type specifically, overpronators should wear motion control shoes. ? Severe overpronators may need orthotics. Have two pairs of shoes and alternate wearing them to vary the stresses on your legs. ? Avoid hills and excessively hard surfaces until shin pain goes away completely and re introduce these forms of training gradually to prevent a recurrence. ? If you frequently run on roads with an obvious camber, run out and back on the same side of the road. Likewise, when running on a track, switch directions. ? If you are prone to developing shin splints, stretch your calves and Achilles regularly as a preventive measure. If shin splints are not treated properly or if exercise is resumed too early or aggressively, shin splints can become permanent. Shin splints can be diagnosed by a physician using gentle pressure to determine whether there is tenderness over a four to six inch section on the lower inside shin area.