By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

COACH’S “AT HOME” TREATMENT FOR SHIN SPLINTS PROBABLY OK

Question: My son recently started running. He now has pain in the front of his lower leg that the coach says is shin splints. Should I take him to the doctor? The coach says these can be treated at home and that he should play through the pain.

Answer: Shin splints are commonly seen in runners, aggressive walkers and those who engage regularly in other forms of aerobic exercise. There are actually several different types of lower-leg injuries that can be referred to as shin splints. They all involve overuse caused by the repeated impact of your feet on hard surfaces.

Tibial shin splints are the most common type. It’s an inflammatory condition that results from injury to the tendon and tissues on the front of the leg, usually along the shin. Characteristically there is pain on the outer edge of the shin, associated with running or walking. The pain can be dull, but can become so severe it can stop the workout.

As a general rule, shin splints of all types occur in runners when there is a major change in the intensity of the workout. They are also more common when the person has been running up hills and on hard surfaces.

Chances are the coach is correct that your son’s shin splints can be treated at home, but a visit to your family doctor would probably be reassuring. Though rare, there can be stress fractures to the lower leg that can cause symptoms very similar to shin splints. Usually a history and physical are adequate to make the diagnosis. If the diagnosis is in question, then X-rays may be indicated.

There are many different treatments for shin splints, and most can be done at home. First, a good shoe that has enough arch support to keep the foot from rolling inward is a must. Sometimes a different shoe or special inserts can cure this problem, which doctors refer to as pronation.

If the shin splints are mild, then several simultaneous treatments can help. Confine your workout to level ground and follow the softest terrain possible. That means avoiding hills and hard surfaces until the pain is gone. Massage the painful area with ice for about 15 minutes after a workout. This will reduce the inflammation. Using a wide ace bandage around the lower leg can help as well. It’s also a good idea to stretch before and after a workout and at least twice a day.

If your son’s shin splints are very painful right now, I’d recommend a non-weight-bearing workout, like stationary bike riding. This can be quite beneficial and promote healing. In this acute phase, the use of anti-inflammatory medication can help reduce the pain and the swelling. Once he resumes regular workouts, it would be a good idea to start with a reduced running distance. He can then gradually work back up to his regular time and distance. This approach will keep him in condition and allow the injury to heal.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.