Fall sports bring increased risk of shin splints

Posted on: September 14th, 2020 by Dr. Ryan C. Enke

With fall comes the return of favorite sports like football, cross country, soccer and field hockey. While such activities bring great joy, camaraderie, and school spirit, they also carry an increased risk of injury for kids and adults alike.

Shin splints (medial tibial stress syndrome) rank among the most common exercise-related problems, typically developing after physical activity. While shin splints are often considered a runner’s ailment, any vigorous activity can bring them on, particularly if someone is just starting a sport or suddenly increases the duration, frequency or intensity of exercise. The repeated pounding on the muscles, tendons, and bone tissue of the lower leg causes repetitive stress to soft tissues, resulting in pain and inflammation.

While any strenuous physical activity may cause shin splints, you are more at risk if you participate in stop-start sports like tennis, racquetball, soccer or basketball. Running downhill, on hard surfaces like concrete, or on uneven terrain also increases the risk, as does having tired leg muscles and tendons or wearing inappropriate or worn-out footwear.

Several other physical factors also contribute to the development of shin splints, including:

• An anatomical abnormality, such as flat feet or high arches
• Muscle weakness in the thighs or buttocks
• Lack of flexibility

What are the symptoms?

The pain that accompanies shin splits may be sharp and razor-like or dull and throbbing. It typically occurs both during and after exercise and may be aggravated when the sore spot is touched. You may also experience tenderness or soreness along the inner part of the lower leg or swelling in the lower leg. Left untreated, shin splints may cause unrelenting pain and progress to more serious problems, like stress fractures.

Most shin splints can be diagnosed through a physical exam. The doctor will ask about the types of activities you enjoy and how often you participate in them. He or she will then examine the lower leg, checking for pain and tenderness along the shin bone. Your doctor may order imaging tests, such as a bone scan, X-ray, or MRI to rule out stress fractures or other shin problems, such as tendonitis or chronic exertional compartment syndrome (an uncommon, yet painful condition that occurs when pressure within the muscles builds to dangerous levels).

How are shin splints treated?

Surgery is rarely performed for shin splints and is reserved for severe cases that do not respond to non-surgical treatment. If you are suffering from shin splits, you will be advised to take a break from vigorous physical activities to give your legs time to heal.

Lower impact cross training can be pursued. The following tips may alleviate discomfort:

• Elevate your legs
• Use ice packs
• Take an over-the-counter anti-inflammatory, such as Advil (ibuprofen) or Aleve (naproxen sodium)
• Stretch your lower leg muscles
• Wear elastic compression bandages
• Use a foam roller to massage your shins
• Wear supportive shoes
• Consider a biomechanics assessment with physical therapy

Shin splints usually resolve with a couple weeks of rest and limited activity. Check with your doctor before resuming physical activities and be sure to ease back into your exercise routine. Begin slowly and gradually increase the duration, intensity and frequency. If the pain returns, stop the activity immediately, ice the area and rest for a day or two before trying again.

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