SHIN SPLINTS |
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DESCRIPTIONShin splints is a catchall phrase for pain in the lower leg brought on by exercise or athletic activity. The discomfort is due to inflammation of one or several body tissues. Pain worsens with exercise using the legs. The muscles (causing myositis), tendons (causing tendinitis), or the bone covering (causing periostitis) may be involved. Appropriate health care sometimes includes physical therapy.
SIGNS & SYMPTOMS
Anterior shin splints: pain in front of the lower leg. The pain radiates down the front and outer side of the child's leg.
Posterior shin splints: pain along the back and inner side of the child's lower leg and ankle.
CAUSES
Inflammation of muscles, tendons, and covering of the bone (periosteum), usually due to an imbalance of the calf muscles (which pull the forefoot down) and the shin muscles (which pull the forefoot up).
RISK FACTORS
Shin splints are most common with marathon running, walking, or jogging, particularly on rough terrain.
PREVENTING COMPLICATIONS OR RECURRENCEInstructions for your child:
Avoid hard and uneven surfaces--use soft surfaces such as dirt or grass for jogging, running, and walking.
Warm up adequately before exercise or competition. Keep shins warm during exercise.
Wear well-fitting shoes with good arch support during physical activities.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; X-rays of the child's lower leg, knee, and ankle.
POSSIBLE COMPLICATIONS
Mistaken diagnosis. Similar symptoms can be caused by stress fractures or increased pressure caused by constricted tissue covering muscles or nerves.
Prolonged healing time if activity is resumed too soon.
Proneness to recurrence.
Inflammation and arthritic changes in nearby joints (such as the ankle, knee, hip, back) caused by a changed gait and posture due to lower-leg pain.
PROBABLE OUTCOME
Complete cure requires rest and slow rehabilitation. Total time may range from 2 weeks to 2 months. Tough competition should be delayed until the child can exercise regularly for 4 to 6 weeks without pain.
TREATMENT
HOME CARE
The child should stop exercising until there is no pain. If there is pain with walking, the child should not try to run.
Use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
Apply heat instead of ice, if it feels better to the child. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Provde the child with whirlpool treatments, if available.
Massage gently and often to provide comfort to the child and decrease swelling. Apply lubricating oil to the skin over the painful area during massage.
For anterior shin splints, raise the heel of the child's shoe with 1/8 inch of adhesive felt.
For posterior shin splints, the child should wear an extra pair of socks and run with the body erect, not leaning forward. The child should try not to land directly on the toes.
MEDICATION
For minor discomfort, use non-prescription drugs such as aspirin or ibuprofen. Your doctor may prescribe other non-steroidal anti-inflammatory medicines.
ACTIVITY
Instructions after treatment, when the child is ready to resume normal activity:
Cut back on your training schedule in proportion to the time it took for the pain to stop.
Ice your legs 6 to 10 minutes before warmup and after running.
Wear long socks to keep your legs warm.
Run only every other day during first few weeks after treatment.
For anterior shin splints, shave your legs and use criss-cross adhesive taping over the front half of your lower leg, with or without an elbow brace.
DIET & FLUIDS
Your child should eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk, and eggs. Increasing fiber and fluid intake helps prevent constipation that may result from decreased activity.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of shin splints that persist despite treatment.
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