Shin Splints: Painful to Have and to Treat

Abstract

When people overuse their legs they develop an uncomfortable awareness of these limbs manifested as a dull burning or aching. The cause is often clear to the person with the problem as a result of the often obvious relationship to overdoing an exercise or activity and the pain. "Shin splints" is the lay term; physicians use the term medial tibial stress syndrome. The pathophysiology that leads to this pain is unclear, although there are a number of competing theories. Differential diagnosis includes stress fractures and compartment syndromes. Bone tumors or lipomas can also cause similar pain to shin splints. Diagnosis can be made by history alone in a majority of cases, but if the diagnosis is unclear, an X-ray and magnetic resonance imaging should be considered. Treatment is still mostly supportive and symptom related. Rest is the most important aspect of treatment. Locally applied cold and anti-inflammatory medication have also been felt to be beneficial.

Medial tibial stress syndrome – A case report

“…Bouche and Johnson (2007) also emphasise that hard surfaces can add to the contractions of leg muscles and thereby increase the strain on the tibial fascia. Story and Cymet (2006) support this by describing changes in activity, surface type and route inclination as contributing factors to MTSS. Worn out shoes are also discussed and noted that after approximately 300 miles shoes can lose their shock absorbing ability and should therefore be changed.…”

“…Kortebein et al (2000), Ugalde and Batt (2001), Couture and Karlson (2002) and Wilder and Sethi (2004) agree that TPBS and MRI have very similar sensitivity in identifying stress fractures. However, Story and Cymet (2006) add that MRI has the added advantage of showing acute changes such as periosteal fluid and bone marrow oedema.…”

“…Story and Cymet (2006) recommend an appropriate period of rest and using appropriate footwear designed to correct running abnormalities such as hyperpronation if appropriate. Also using appropriate surfaces for the chosen type of sport or activity, for example using a padded dirt surface for running instead of concrete or grass (too hard/soft, respectively).…”

“…These are: stress fractures, periostitis and deep posterior compartment syndrome (DPCS) ( Detmer, 1986). It is noted that while still popular, the term 'shin splints' will not be discussed due to many authors considering it to be an ill defined lay term used to describe overuse injuries in the lower leg (Beck and Osternig, 1994;Ugalde and Batt, 2001;Story and Cymet, 2006;Bouche and Johnson, 2007)) and should therefore be disregarded as a final diagnosis.…”

Inyecciones locales multipuntuales con corticosteroide para el síndrome de estrés tibial medial: un nuevo enfoque

“…Currently, little evidence exists in the literature to support the use of the most commonly applied interventions for the treatment of MTSS (13). Traditional treatments include local cryotherapy, stretching and strengthening of gastrocnemius-soleus musculature, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), iontophoresis with calcium or corticosteroids, modification of training regimens, orthotic devices to correct for biomechanical abnormalities, and rest (10,(21)(22)(23)(24)(25)(26).…”