Long distance runners are in the midst of both cross-country and marathon running seasons. Running on trails or asphalt can lead to lower leg pain. Shin splints, also known as medial tibial stress syndrome, is a general term used to describe lower leg pain.
The lower portion of the leg consists of two large bones: the tibia and the fibula. A membrane between these bones, the interosseous membrane and the anterior intermuscular septum, form four compartments. These compartments consist of an intricate network of muscles, arteries, veins and nerves that allows the ankle to move in multiple directions.
Shin splints are often associated with changes in running patterns. They can be attributed to using different types of footwear including excessively worn running shoes, rapidly increasing running distances and association with other injuries in the same or opposite extremity.
Compartment syndrome is among the most serious conditions that may be mistaken for shin splints. This syndrome consists of increased pressure within one of the four compartments of the lower leg. The increased pressure is a direct result of an injury causing swelling within a closed space.
The increased compartment pressure results in an inability for venous blood to drain and arterial blood to enter. The consequence is a lack of nutrients and oxygenated blood to muscles and nerves causing these tissues to atrophy and cease to function.
“The first step in treating shin splints is to find the cause,” reports Ms. Janeen Beetle, head athletic trainer at Norwich Free Academy. “Ice cup massage combined with anti-inflammatory medications provides the best treatment. Strengthening lower extremity muscles can help prevent recurrences.”
Careful evaluation of lower leg pain can avoid serious complications.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu
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