This ‘reasonably common’ exercise-related problem is more likely to affect runners, dancers, children with vitamin D deficiency

Talking about the condition, Dr Sudhir Kumar, a Hyderabad-based neurologist, tweeted that the pain is usually felt in the inner border of the tibia, where muscles attach to the bone. “It is important to get properly evaluated by an orthopaedic surgeon and undertake physiotherapy,” he wrote, adding that rehabilitation exercises for shin splints can also help.

You could be suffering from “shin splint”. Get properly evaluated by an orthopedic surgeon and physiotherapy. You would require rehab for shin splint.. https://t.co/395LRBKTPN https://t.co/LZ55BP1OYj pic.twitter.com/51whTFMDzr

— Dr Sudhir Kumar MD DM (@hyderabaddoctor) March 24, 2023

For the unversed, the tibia is the shin bone. It’s the second longest bone in your body and is an important part of your ability to stand and move, as per Cleveland Clinic.com.

Causes

According to Dr Ankit Batra, orthopaedic surgeon, Sharda Hospital, several conditions can cause shin pain, including stress fractures, tendinitis, or simple over-exertion.

Other factors that may increase the chances of shin splints include:
-Having flat feet or abnormally rigid arches of one’s feet.
-Improper footwear, especially during exercise.

Concurred Dr Yadav and said that the constant stress on the lower leg leads to “small tears in the muscles, and inflammation of the tissue around the tibia, which results in pain and tenderness”.

Are you wearing proper footwear? (Source: Getty Images/Thinkstock)

Who is more prone to shin splints?

Runners, dancers, cricketers, and military recruits are among those “frequently diagnosed with this condition,” said Dr Batra.

But the severity of this “reasonably common” condition, according to Dr Kumar, varies depending on the runners’ mileage — more common in those who run longer distances. “Even those who walk or run (excessively) on treadmills are prone to getting shin splints,” he added.

According to Dr Chirag Thonse, consultant – orthopaedic, Joint Replacement and Arthroscopic Surgeon, Manipal Hospital, Millers Road, Bangalore, children with vitamin D deficiency or weak bones are also prone to it. “Additionally, people in the gym who only do cardio are susceptible to it because running on hard surfaces with non-cushioned shoes can trigger shin splints, as can landing on legs repeatedly in the wrong posture or playing on uneven surfaces,” said Dr Thonse.

Diagnosis

We order X rays and a few other tests to rule out other shin problems, said Dr Batra. Other tests in terms of calcium, vitamin D, or a bone density test may be conducted to identify any underlying osteoporotic changes in the bone, and supplements may be prescribed as necessary, added Dr Thonse.

Treatment and prevention

Most cases of shin splints can be treated with rest, ice and other self-care measures. “Nonsteroidal anti-inflammatory medicines, drugs like Paracetamol, ibuprofen etc will reduce pain and inflammation. Wearing proper footwear and modifying your exercise routine can help prevent shin splints from recurring,” said Dr Batra.

He added, “Rest is the most important. As it is an overuse injury, the activity that caused it must be stopped till recovery.”

-Ice, cold fomentation for 20 minutes at a time, several times a day helps reduce associated swelling and edema
-Swimming is one of the low impact activities that may be done during recovery.
-Proper and supportive footwear for  everyday activities will help reduce stress in your shins.

Dr Kumar also recommended some simple exercises that can help with shin splits, courtesy physical therapist Dr Scott Carlin.  Follow this Twitter thread.

Sample Rehab Program:

Shin Splints

🧵

— Dr. Scott Carlin (@scottcarlinpt) March 18, 2023

Dr Carlin also listed a few measures to consider

*Rule out stress fracture
*Temporarily reduce or eliminate running (no painful running).
*Cross-train to allow bone repair.
*Strengthen the entire leg.
*Consider insoles or new shoes.
*Gradual return to pain-free running.

Concurred Dr Yadav and detailed some measures for slowly resuming activities.

*It’s important to wear proper footwear that fits well and provides good support, cushioning, and shock absorption.

*Sudden increases in activity should be avoided, and instead, the intensity, duration, and frequency of physical activity should be gradually increased to allow muscles to adjust.

Make sure you do stretching exercises (Source: Getty Images/Thinkstock)

*Stretching exercises before and after exercise can improve flexibility and reduce muscle tension. Strengthening the muscles in the lower legs can also help prevent shin splints.

*Cross-training by alternating high-impact activities like running with low-impact activities like swimming or cycling can reduce the strain on your legs

*Proper exercise techniques, such as avoiding over-striding, maintaining good posture, and landing softly on your feet, can also help prevent shin splints.

*Allowing time for rest and recovery between workouts, particularly if you are experiencing pain or discomfort, can also reduce the risk of developing shin splints and other lower leg injuries.

Dr Thonse had a word of caution. “It is very important for sportsmen that they get a good foot assessment and functional assessment of their lower limbs to prevent this condition. Also, periodic assessment of bone quality and the levels of vitamin D and calcium may be important. A good diet and intake of antioxidants and vitamin B-rich food to some extent help in avoiding shin splints,” said  Dr Thonse.

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