The term “Shin Splints” is generally misused and poorly understood by most people; it tends to be used as a catchall term to encompass one or more of three conditions: chronic exertional compartment syndrome (CECS), medial tibial stress syndrome (MTSS), and/or a stress fracture.
In most cases, patients refer to tightness/burning/numbness/pain located along the front of the lower leg that is aggravated during activity and can be so severe that it actually restricts the participant from continuing or even engaging in the activity.
The lower leg is broken down into 4 compartments: lateral, posterior, deep posterior, and anterior. Check the following link for a visual of the compartments:
http://www.hughston.com/hha/a_17_2_1.htm
CECS
This condition refers to a localized feeling of tightness, burning or pain associated with increased pressure of one or more of the compartments. Activity causes an increase in blood flow within the lower leg muscles which increases the pressure exerted against the fascial covering of the compartment(s); this may compress muscle, blood vessels and/or nerves. Fascia is a tough sheath that covers muscle and does not expand as easily or quickly (imagine a balloon trying to expand in a closed off box). This condition generally acts to impair the function of the muscles involved. Feelings of numbness or pain in the foot have also been reported in association with this condition. The feelings of pain and tightness do not generally persist upon cessation of the activity.
MTSS
MTSS accounts for 10-15% of all running related injuries and approximately 60% of conditions that cause pain in an athlete’s leg. It is caused by repetitive microtrauma (muscular pulling at the tibia). Contributing factors may include: weakness of the legs, shoes with poor support, running on hard surfaces or overtraining, misalignment problems, tight heel cord, overpronation, or forefoot supination. Pain is felt along the posterior medial (lower and inner) aspect of the tibia and is categorized within 4 grades based on severity. This condition may lead to a stress fracture if left untreated; x-rays are usually performed to rule out stress fractures. Pain at night may be experienced with this condition. Treatment includes a gradual and lengthened warm-up, avoiding the contributing factors listed above, sufficient warm-down and ice massage following activity. Orthotics and a gastrocnemius-soleus flexibility program may also help.
As usual, prevention is key – do your best to ensure that you incorporate a sufficient warm-up and warm-down, include both strength and flexibility training into your routine, use ice to decrease pain and inflammation, and do not put off seeing a Sports Physician or Chiropractor to address any concerns with your condition; correction or biomechanical faults is also of primary concern (i.e. misalignment, overpronation, etc).
Prentice, W.E. (2003). Arnheim’s Principles of Athletic Training: A Comprehensive Apporach (11th ed.). New York: McGraw-Hill.
