Shin Splint Syndrome: Causes, Symptoms & Treatment

Shin splint syndrome is the occurrence of pain at the front edge of the shin bone. The discomfort mainly manifests itself after sports activities.

What is tibial plateau syndrome?

In medicine, tibial tendon syndrome is also known as tibial plateau syndrome or shin splint syndrome. This refers to a chronic pain syndrome that occurs primarily after athletic activities such as intense jogging. The same applies to all sports that place greater stress on the muscles of the shin. The healing process, which often progresses slowly, is considered problematic.

Causes

Shin splint syndrome is usually caused by intensive running training, long hikes, and sports such as long jump or high jump. In principle, however, any sport that leads to intense movements can be a trigger for shin splint syndrome. Thus, skateboarding is also one of them. Among athletes, shin splint syndrome is one of the most common sports-related complaints, ranking third. The origin of the pain is thought to be changing ground surfaces in spring and fall, technical changes in tempo running within interval training, and pronounced marathon training. Similarly, sudden increases in running pace or training volume may be responsible for the onset of shin pain. Another conceivable trigger is wearing the wrong footwear. However, shin splints are most frequently caused by constant jumping and landing. Athletes with increased pronation, whose foot rotates in the outer direction and who use spikes are also particularly affected. In addition to athletes, dancers and soldiers also frequently suffer from the pain syndrome.

Symptoms, complaints and signs

Shin splint syndrome is noticeable by the abrupt onset of severe pain at the edge of the shin. If the load is reduced, the pain subsides. If the load is increased again, the affected athlete immediately feels pain again. Doctors distinguish between two forms of shin splint syndrome. There is medial and lateral tibial crest syndrome: In medial tibial crest syndrome, the pain occurs in the lower section of the tibial crest. The lateral form, on the other hand, manifests in the upper section of the tibial edge. The pain is felt as either sharp or dull. While it initially manifests only during movement, it may also occur at rest as it progresses. Due to the strong pressure on the affected areas, the skin sometimes presents with strong elasticity. Pain is also possible due to the skin tension. Some patients also experience sensory disturbances in the tense skin areas. In some cases, the strong pressure affects the muscles, which in turn restricts certain muscle movements. Sometimes necroses also form in the affected muscle areas. This can cause further discomfort such as fatigue and high fever. In the worst case, life-threatening sepsis (blood poisoning) sets in.

Diagnosis and course of the disease

If shin splint syndrome is suspected, the attending physician first conducts a detailed discussion with the patient. In doing so, he inquires about the stresses at which the complaints occur and whether they have already manifested themselves on previous occasions. An important role is also played by the patient’s walking pace and whether there are any previous thromboembolic diseases. Following the anamnesis, a physical examination is performed. In most cases, a swelling along the edge of the tibia can be observed. If the physician applies pressure to the swelling, pronounced pain is evident. In addition, the physician uses imaging examination methods such as taking X-rays. In this way, stress fractures or inflammation of the periosteum can be identified. It is also possible to perform magnetic resonance imaging or scintigraphy. These procedures are mainly used when a stress fracture is suspected. Differential diagnoses are also important in order to rule out other diseases that could be responsible for complaints of this type. These include compartment syndrome, peripheral arterial occlusive disease of the lower limbs, and venous outflow disorders.The course of shin splint syndrome varies greatly from patient to patient. While in some sufferers the complaints only last a few hours, others suffer from them for several weeks. If the tibia is not spared, the pain continues to increase in intensity and the condition lasts longer.

Complications

In this syndrome, sufferers primarily suffer from very severe pain. The pain occurs mainly in the shin, so that there may also be restrictions in movement and thus in the daily life of the affected person. As a rule, the pain occurs during exertion. However, it can also occur in the form of pain at rest and can also cause discomfort at night. As a result, many patients also suffer from sleep disturbances or psychological upsets. Paralysis or other disturbances of sensitivity can also occur as a result of tibial plateau syndrome and continue to complicate the daily life of the affected person. Necrosis develops and sufferers often appear tired and fatigued. Furthermore, the tibial plateau syndrome can also lead to blood poisoning, which in the worst case can lead to the death of the affected person. Likewise, the syndrome can lead to a severe fever. Treatment of this syndrome can usually be done with the help of medications. Complications do not occur. However, many sufferers also rely on various exercises to restore mobility. The patient’s life expectancy is also not negatively affected by the syndrome.

When should you see a doctor?

In the case of tibial plateau syndrome, a visit to a doctor is usually always necessary. There can be no self-healing in the process, so the condition must always be examined and treated by a doctor. This is the only way to prevent further complications and discomfort. A doctor should be consulted if the affected person suffers from very severe pain in the shin. The pain can occur in the form of pain on exertion or pain at rest and can have a very negative effect on the quality of life of the affected person. Especially stabbing pains indicate the shin splint syndrome and should be examined by a doctor if they occur over a longer period of time. Furthermore, high fever or severe fatigue are also indicative of shin splint syndrome if the symptoms persist over a longer period of time. If the tibial plateau syndrome is not treated, it can also lead to blood poisoning in the worst case. Shin splint syndrome is diagnosed and treated by an orthopedic surgeon. In emergencies or in case of acute pain after an accident, the hospital can also be visited or an emergency doctor can be called directly. The life expectancy of the affected person is usually not reduced by this disease.

Treatment and therapy

As a rule, the treatment of tibial plateau syndrome is conservative. The focus is particularly on sparing the leg. If further training is required, it must be limited to exercises that do not cause stress to the tibia. These include cycling or swimming. In the case of acute tibial tendon syndrome, the patient can apply ointment dressings with analgesic agents. Another option is to take painkilling tablets. If these treatments do not lead to an improvement, a cortisone solution can be injected into the affected areas. Physiotherapeutic exercises are also considered helpful. If the symptoms persist despite conservative treatment measures, surgery may be advisable. In this case, the surgeon splits the fascia of the muscle to achieve a reduction in pressure. Minimally invasive endoscopic procedures are increasingly being used for this purpose instead of open surgery. The chances of success of the operation are considered to be positive. For example, more than 60 percent of all patients no longer feel any discomfort after the procedure. After about four weeks, patients can resume sports activities.

Prevention

Preventive measures can be taken to prevent tibial plateau syndrome. For example, the athlete should not increase the amount of training he does in a week by more than ten percent. In this way, he gives his tendons and muscles enough time to prepare for the new loads. Suitable running shoes are also important.

Aftercare

Affected individuals should urgently wear shin guards when performing any sports.This can provide sufficient protection against complications in the event of accidents and unwanted external effects. If the affected person notices pain or other complications, a break should be taken immediately. In such a case, the affected tibia must be sufficiently spared. Affected individuals should generally take plenty of rest and recuperate so that improvement can occur quickly. All activities that are carried out should therefore be urgently adapted to the disease. This also applies to the occupation. If a profession is practiced in which the shinbone is subjected to a lot of strain, sufferers should consider changing this profession. Physiotherapy should also be sought out. There, sufferers can learn how to avoid incorrect postures so that no additional stress is placed on the shinbone. The shoes of the affected person must also be adapted to the disease. The size of the shoes must be appropriate for the foot and the shoes should have no heel or only a limited heel. Sufferers should consider putting insoles in their shoes. This can lead to rapid relief of the symptoms. Affected individuals should also take care to prevent one-sided stress on the body, as this can also lead to worsening of the symptoms.

What you can do yourself

When performing sports activities, adequate protection of the shin should be worn. This helps protect against unwanted external impacts, cushions any accidents and can protect against severe strain. If the first disturbances or impairments occur, periods of rest should be taken and the body should be adequately rested. A period of regeneration is needed so that complaints can be alleviated and an improvement can occur. In principle, the performance of physical activities must be adapted to the needs of the affected person and his or her organism. Situations of overload are to be avoided. In everyday life, physiotherapeutic exercises can be carried out on one’s own so that no incorrect strain is created or an incorrect posture is adopted. The footwear worn should be checked and optimized if necessary. The heels should not be too high and the shoe should be adjusted to the size of the foot. In some cases, relief of the symptoms already occurs when insoles are worn. In addition, it should be checked on which floor surface the affected person moves around a large part of the time. For example, a surface that is too hard can trigger an increase in physical irregularities when walking. In the context of self-help, care should be taken to avoid one-sided physical stresses. These can have a negative influence on the skeletal system or the musculature.