From playing basketball to starting a running program to training for the Chevron Houston Marathon, athletes who run and jump are susceptible to shin splints. This overuse injury, caused by improper running mechanics, conditioning or footwear, includes pain that runs along the front or inner edge of the large tibia bone of the lower leg.
Shin splints are preventable and often occur with a change in training intensity or running surface, particularly on sloped or uneven surfaces. Treatment includes rest, ice, anti-inflammatory medications and stretching.
“If self-care measures do not relieve lower leg pain, it is important to seek medical treatment to make sure the pain is not due to a stress fracture or a more serious underlying condition,” says Raj Shani, M.D., a board-certified orthopedic surgeon affiliated with Memorial Hermann Greater Heights Hospital and the Memorial Hermann IRONMAN Sports Medicine Institute.
Preventing shin splints
Shin splints disrupt the connective tissue that attaches the muscles to the tibia. In addition to pain, there may be mild swelling. The pain generally worsens with activity and eases with rest, though pain can be intense upon rising from sleep.
Tight calf muscles, caused by muscle imbalances and flat feet, increase the risk of shin splints. Proper warmups, including calf stretching, are necessary, as is the avoidance of hard surfaces when running and jumping. Orthotics can provide arch support to flat feet.
“If an athlete experiences reoccurring shin splints, a gait analysis may help,” says Dr. Shani who lives in the Heights and serves as team physician for athletes at Waltrip High School, Lutheran North High School, St Pius X High School and the University of St. Thomas. “A running analysis can detect subtleties in gait mechanics that can be corrected to prevent this injury.”
Along with improving calf strength, athletes should work on hip abductor strength and pelvic stability. The hip extensor muscles, hamstrings and glutes work together to generate a powerful stride and help avoid shin splints.
“Core muscles are also important to build a strong, balanced structural system and avoid injuries,” adds Dr. Shani who will provide medical support during next month’s Chevron Houston Marathon.
Never play through the pain
A stress fracture in the tibia or fibula bones of the lower leg can feel exactly like shin splints, so Dr. Shani urges athletes not to ignore lower leg pain and especially to never “play through the pain.” He points to an undetected stress fracture as the probable cause of University of Louisville basketball player Kevin Ware’s shattered tibia and fibula upon landing from a routine jump during the 2013 NCAA Midwest Regional finals.
Other conditions that cause lower leg pain include exertional compartment syndrome, an exercise-induced muscle and nerve condition, and popliteal aneurysm, a ballooning of the popliteal artery behind the knee.
“It is important that these aneurysms be closely monitored or corrected surgically, as they present a risk for blood clots,” says Dr. Shani, an assistant professor of orthopedic surgery at McGovern Medical School at UTHealth.
To learn more about sports medicine care at Memorial Hermann Greater Heights, visit memorialhermann.org/heights.