Is Shin Splints A Serious Condition?
No, shin splints or tibial stress syndrome is not a serious condition. You will understand why when you read this article.
Shin splints are a common sport injury due to overuse of the lower leg. Incidence in the athletic population ranges from 4% to 19% and in military population 4% to 35%. Runner, (sprinters, middle and long distance runners) football players are the common category to get shin splints and the incidence is about 13.6 to 20% with a prevalence of 9.5%. In dancers the incidence is about 20%. The incidence in new runners and dancers is about 35%.
Women are at increased risk of getting shin splints more than men. This can be attributed to the hormonal, nutritional and biomechanical factors. People who are overweight or obese are also at risk of getting shin splints more. Cold weather also tends to cause shin splints; therefore, warming up before exercises properly is important.
Structure Of The Lower Leg
There are four muscle compartments in the lower leg which are:
- Tibialis anterior – this muscle dorsiflexes (flex the foot upwards) the ankle and inverts the foot
- Extensor hallucis longus – extends the big toe
- Extensor digitorum longus – extends other toes and helps in eversion
- Peroneus tertius – eversion of the foot
- Tibialis posterior – plantar flex (flex the foot downwards) and invert the foot
- Flexor digitorum longus – flex the toes
- Flexor hallucis longus – flex the toes
- Gastrocnemius, soleus and plantaris muscle. All three muscles plantar flex the foot
- Peroneus brevis – evert the foot
- Peroneus longus – evert the foot
There are two types of shin splints:
Medial Tibial Stress Syndrome: Medial (posteromedial) tibial stress syndrome (MTSS). This is the commonest type, the cause for MTSS is believed to be periostitis of the tibia due to the overload on the tibia. However, new research says it’s just not periostitis, but other injuries like tendinopathy; periosteal remodeling and stress reaction can contribute to shin splints. These tibial stress injuries occur due to the increased repetitive workload on the tibia and bending of the tibia. That occurs due to the dysfunction of the tibialis posterior, tibialis anterior and soleus muscles. Muscle imbalance, tightness, inflexibility and weakness of the muscles lead to dysfunction of the muscles.
However, the exact pathophysiology behind shin splints is unknown.
Anterior (Anterolateral) Tibial Stress Syndrome: This is quite rare type of shin splint
With above details you must have understood why we said that shin splint is not a serious condition. Most of the time rest from the physical activity that caused shin splints resolve the condition although, in some people shin splints tends to recur. Usually treatment for shin splint is conservative management. If shin splints recur or do not respond to conservative treatment, then there are few surgical options for you.
Fasciotomy: Fasciotomy of the deep posterior compartment involves a cut in the fascia that surrounds the posterior compartment muscles. This can sometimes relieve the shin splint. This is helpful if the cause of shin splint is damage to the fascia of the lower leg.
Periosteal Stripping: In this surgery a thin band of connective tissue that surround the tibia is removed which is called the periosteum. This is helpful if shin splint is caused by periostitis.
No, shin splint or tibial stress syndrome is not a serious condition. It is common sports injury and the incidence in the athletic population ranges from 4% to 19% and in military population 4% to 35%. In dancers the incidence is about 20%. The incidence in new runners and dancers is about 35%. There are two types of shin splints medial tibial stress syndrome which is the common type and involves the posterior compartment muscles. Anterior stress syndrome type is rare. Shin splints are a common sport injury due to overuse of the lower leg. Most of the time rest from the physical activity that caused shin splints resolve the condition. Usually treatment for shin splint is conservative management. If shin splints recur or do not respond to conservative treatment, then there are few surgical options such as fasciotomy and periosteal stripping.
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