Shin Splint Stress Fracture
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Shin Splint Stress Fracture

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More than likely, every athlete has, at one point in his or her career, experienced pain in the anterior part of the lower leg, or the shin. An injury such as this is known as a shin splint. A shin ...

More than likely, every athlete has, at one point in his or her career, experienced pain in the anterior part of the lower leg, or the shin. An injury such as this is known as a shin splint. A shin splint, more formally known as medial tibial stress syndrome (MTSS), is a term that indicates pain in the anterior part of the shin. There are several factors that can contribute to a shin splint injury, including weak lower leg muscles, shoes that do not provide enough cushioning or support, and training errors. Those who suffer from varus foot, a tight heel cord, a hyper mobile pronated foot, or forefoot supination are more likely to acquire shin splints.

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Shin Splint Stress Fracture Shin Splint Stress Fracture Document Transcript

  • Alex Agos Kim Anderson Sports Medicine 1 06 October 2011 Shin Splint Stress Fracture More than likely, every athlete has, at one point in his or her career, experienced pain in the anterior part of the lower leg, or the shin. An injury such as this is known as a shin splint, and can be incredibly debilitating. According to William E. Prentice, a shin splint, more formally known as medial tibial stress syndrome, is a term that indicates pain in the anterior part of the shin. Conditions including muscle strains, stress fractures, and chronic anterior compartment syndromes have all been termed shin splints. MTSS is not uncommon in sports such as running, and it accounts for about 10-15% of all injuries obtained during this activity. In addition, shin splints account for up to 60 percent of all activities that cause leg pain in athletes. MTSS is caused by small traumas to the leg that occur repeatedly, and is seen mostly in sports that involve running or jumping. There are several factors that can contribute to a shin splint injury, including weak lower leg muscles, shoes that do not provide enough cushioning or support, and training errors, including running on hard surfaces or overtraining. In addition, if the foot is not properly aligned, shin splints become more likely. Those who suffer from varus foot, a tight heel cord, a hyper mobile pronated foot, or forefoot supination are more likely to acquire shin splints. Prentice also states that MTSs involves one of two syndromes. These syndromes include either a tibial stress fracture, or an overuse syndrome that can lead to an irreversible, exertional compartment syndrome.
  • The only real symptom of medial tibial stress syndrome is pain, but there are four specific grades of pain that are used to determine the severity of the shin splints. In grade one, pain only occurs after activity. In grade two, pain occurs before and after activity, but not during it. In grade three, an athlete has pain before, during, and after activity, and in grade four, the pain is so severe that an athlete is unable to perform any sort of activity. Oftentimes, management of medial tibial stress syndrome is difficult, as there are several factors that can contribute to the development of the injury. First and foremost, a physicians’ referral is necessary to rule out the possibility of a stress fracture. According to Joe English, however, x-rays may not be sufficient in diagnosing a stress fracture, as the cracks in the bone may be too small to see. Instead, a bone scan or an MRI may be necessary. Once it is clear that the injury is, in fact, shin splints, treatment will include activity modification (including measures to maintain cardiovascular fitness), correction of the abnormal gait that may have contributed to the injury (which can be done through more supportive shoes or through custom orthotics), a 20-minute ice massage up to three times a day, and a flexibility program for the Gastrocnemius and the Soleus muscles (so as to prevent shin splints from occurring in the future). Since shin splints can eventually lead to stress fractures, it is important to be able to differentiate the two injuries. There are a few ways to do this; obviously, the most conclusive way is through bone scans and MRI’s. However, there are also some special tests that can be used. One of these tests is known as the Hop Test. If the athlete is able to hop on the injured leg, then chances are, he or she is simply suffering from shin splints. If an athlete is unable to hop on the injured leg because it causes too much pain, it is most likely a stress fracture and should be treated immediately. Another way to tell is through palpations. If the athlete’s entire shin is
  • tender, then he or she is most likely just suffering from shin splints, but if the athlete is more tender in specific areas than in others, then the injury is probably a stress fracture. In addition, an athlete suffering from shin splints will not have pain during normal activities, while an athlete suffering from stress fractures will have difficulty with everyday tasks (walking, going up stairs, etc.). Perhaps the most effective way to treat a shin splint is to prevent it in the first place. There are several ways to do this, including slowly and safely increasing the mileage that an athlete runs, stretching before and after activity, wearing appropriate footwear, and cross training. An article published online by Active.com states that stretching the Achilles tendon and calves will help prevent shin splints. The authors of this article also suggest having two pairs of running shoes; this will vary the stress put on an athlete’s legs, and could help alleviate shin splints that may eventually lead to stress fractures. Another less obvious preventative measure is to run out and back on the same side of a road. This prevents additional stress on an athlete by limiting the amount of rough terrain he or she runs on. While shin splints may be bearable, and they may not seem like a huge deal when they initially show up, it is important to care for and treat this injury carefully. If shin splints are not cared for properly, they will develop into stress fractures, which will require more rehabilitation and thus, more time away from one’s sport of choice. I will be the first to admit that I do not enjoy taking the time necessary for my body to recover after vigorous activity; after an injury, I’m always back either running or dancing several weeks before my doctor has told me to do so. While this has not caused me any complications so far, I know that if I do not take the time to allow my body to fully heal after an injury, I will eventually re-injure it. This is the case with shin splints, and it is why this seemingly mediocre injury should be taken seriously. Shin splints
  • are not the injury to mess with, and they will eventually lead to a worse injury if not taken care of correctly.