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Shin Splints 

Introduction
Shin splints is a term to describe pain at the front or lower inside edge of the leg.  The pain is most frequently caused by muscle overuse, improper form when exercising, or wearing the wrong type of athletic shoes.  Most cases of shin splints resolve with rest.  In rare cases, surgery may be necessary to treat complications from shin splints.

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Anatomy
Your leg contains two bones.  The larger bone is the tibia, and the thinner bone is the fibula.  The tibialis anterior muscle connects at the front of the tibia.  You use your tibialis anterior muscle to move your foot upward and control the lowering of your forefoot when you walk.  The tibialis posterior muscle attaches at the back inside edge of the tibia and fibula.  You use your tibialis posterior muscle to turn your foot inward and down and lift your heal when walking. 

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Causes
Shin splints is the term for pain that occurs on the front or inside edge of the tibia or "shinbone". 
The pain occurs when the edge of the tibialis muscles pull away from the bone from repeated stress or overuse.  This causes the muscles and the covering of the bone (periosteum) to become inflamed. 

Overused muscles from running or jumping most commonly cause shin splints.  They can occur in athletes that play sports that require quick starts and stops, such as basketball or tennis.  Shin splints commonly occur in people that participate in more athletic activity than their bodies are prepared for.  Shin splints can also result from wearing shoes with poor shock absorption or running on hard surfaces. 

Shin splints are described as anterior or posterior, depending on the muscle groups involved.  Anterior shin splints usually result from using improper form while taking strides or running downhill.  Posterior shin splints are typically related to an imbalance in leg muscles or flat feet.

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Symptoms
Shin splints cause a dull aching pain on the front or inside lower part of the leg.  The pain may increase when you move your legs, climb stairs, or walk.  The pain typically goes away with rest and may be worse when you first wake up in the morning.  The sore area occasionally appears red and swollen. 

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Diagnosis
Your doctor can diagnose shin splints after reviewing your medical history and completing a physical examination.  You should tell your doctor about your symptoms, exercise activities, and the types of shoes that you wear.  X-rays will be ordered to rule out stress fractures.  In select cases, a magnetic resonance imaging (MRI) scan may be ordered to show a more detailed view of your tendons and bones.

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Surgery
In rare cases, surgery may be necessary for complications related to shin splints, such as bone avulsion or compartment syndrome.  Surgery can be required if part of the bone has torn away and needs repair.  A fasciotomy is a surgical procedure used to reduce the pressure in the leg.  Most surgeries are followed by a period of physical therapy.

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Treatment
The majority of shin splints resolve with rest.  It is helpful to stop the activity that caused the condition until your symptoms go away.  Anti-inflammatory medication and cold packs may ease your pain.  In rare cases, cortisone injections are used to treat pain.

Your doctor may recommend shoes that are appropriate for your sport or activity.  If you have flat feet, it may be beneficial to use an arch support.  Specialists can fabricate custom made orthotic insoles for your shoes.

Your doctor may refer you to physical therapy for pain control, rehabilitation, and training tips.  Physical therapists can provide treatments to reduce your pain, such as ultrasound.  Physical therapists can teach you how to properly stretch and strengthen your muscles.  You will also learn correct postures and form to improve your running style and suggestions for avoiding muscle overuse.

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Recovery
The recovery process is different for everyone.  The length of your recovery period depends on many factors including the extent, type, and location of your injury and the type of treatment that you receive.  Your doctor will let you know what to expect.

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Prevention
You can prevent shin splints by preparing your body before intense exercise with strengthening and conditioning exercises.  Rest when you need to and do not overdo it; instead, increase your exercise program gradually.  Use proper form when you walk, jog, or run.  It is helpful to exercise on level surfaces that help to absorb impact.  Make sure that you are wearing the correct athletic shoes, arch supports, or insoles for your activity.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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