Editor’s Note: In the latest installment of a monthly series on common sports injuries, Dr. Dena Florczyk, from the Arthur Ashe and Wellness Center, discusses shin pain and shin splints.
By DENA FLORCZYK
Shin splints are a common cause of shin pain in runners and those who participate in sports that involve running, such as soccer, basketball, Ultimate Frisbee, football or rugby.Most commonly, shin pain is an overuse injury, resulting from a rapid increase in running mileage, increase in running intensity or change in running surface. Additionally, increased flattening of the arches, when the foot lands on the ground – called overpronation – may contribute to shin pain.
Shin splints are characterized by pain located in the lower leg between the knee and the ankle that usually begins during or after intense exercise but improves with rest. Pain is typically located over the front of the shin bone, also known as the tibia, but one may also feel pain across the muscles surrounding the shin bone. Pain that is located over a single point of the bone, pain that persists despite cessation of exercise, or causes nighttime pain is more concerning for a stress fracture of the bone rather than shin splints.If shin pain is associated with swelling of the leg compartments, numbness or tingling, this may be due to compartment syndrome and requires immediate medical evaluation.
The initial treatment of shin splints should include resting from high impact activities, such as running or jumping or any painful activity, icing the shin for 10 to 20 minutes every four to six hours and taking an over-the-counter pain medicine such as ibuprofen (Motrin, Advil), naproxen (Aleve) or acetaminophen (Tylenol). If you have flattened arches, consider using an arch support or orthotic, which can be bought in the store or custom made to correct the overpronation.
During recovery from shin splints, you may begin low impact activities such as swimming or biking to maintain aerobic fitness, in addition to working on strengthening and stretching of the calf muscles and lower leg compartments. It is safe to begin a slow progression back to running once you have been pain-free for three to five days. The running progression should start at 25-50 percent of previous running volume while the overall mileage should be increased by no more than 10 percent per week.
Preventive measures for shin splints include gradually increasing physical activity, wearing shoes with appropriate support, choosing soft running surfaces (grass, dirt trails), warming up properly and maintaining flexibility in the leg muscles. If shin pain does develop, reducing activity is advised, as it can take longer for the pain to resolve if running continues.
You should see your health care provider if your shin pain persists despite the above measures, if you are unable to return to your previous level of activity because of pain, if your pain is localized to one particular spot on the shin or if you have nighttime shin pain or associated numbness or tingling or weakness of your leg.
Dr. Florczyk is a sports medicine physician at the Arthur Ashe Student Health Center.