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What are shin splints? How can they be managed? K.T.

Dear K.T.: The term “shin splints” refers to pain along the shin bone (the tibia) in the front of the lower leg. The medical term for the condition is medial tibia stress syndrome. Shin splints occur when too much force is placed on the tibia and the tissues that attach muscles to the bone. Activities that are most likely to cause shin splints are running downhill, running on a slanted or tilted surface, running in worn shoes, and participating in activities with frequent starts and stops such as basketball and tennis. The condition can also be caused by running too hard, too fast, or for too long. The running surface also matters; the harder the surface the greater the likelihood that shin splints will develop. Having flat feet increases the risk as the feet tend to roll inward in this condition.

Management involves avoiding activities that cause pain or swelling, icing the affected area for ten to fifteen minutes three or four times daily, elevating the leg if swelling is present, and using orthotics when the activity is resumed. Orthotics are firm plastic shoe inserts that cause the foot to assume an ideal position, preventing the inward rolling that stresses the tissues of the lower leg. Systemic enzymes, such as Panzymes, can significantly speed recovery. Six capsules are taken on an empty stomach three times daily initially. The amount is tapered as pain and swelling resolves. If the pain persists or increases in spite of these measures further evaluation is indicated, as this may indicate that a stress fracture is present.

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