Shin Splints Unveiled: When To Worry About Shin Pain

When I was growing up playing sports in the 80’s and 90’s I was often told “you’re fine, just walk it off” or “tough it out.”  This was the response a lot of my coaches had to injuries back then.  Sometimes it worked out okay and other times it meant that injuries would linger longer than they probably had to.

I think a lot of the coaches today are beginning to take injuries more seriously, but there are still some coaches out there that are just old school or don’t know any better who have the “just tough it out” attitude.  Athletes also place a lot of pressure on themselves to perform even when they are injured.  Sometimes they don’t even tell their coach that they have an injury because they don’t want to be pulled out of competition.

One particular injury that I see a lot of in my practice is shin splints.  Most people think of shin splints as pain in the shin that usually happens with running.  Sometimes shin splints only bother athletes when they start running and then they warm up and feel fine.  Other times their shins bother them more often.  Let’s try and figure out when shin splints are a problem and when they’re not.

When Shin Pain Is Okay

If you have shin pain just at the beginning of competition and then things feel better as you warm up and you have no pain after the competition, it is probably not a serious problem.  Sometimes your muscles over your shins just need time to adjust to playing your sport again and then you don’t feel them anymore.

My mother complains of this every spring when she starts her walking regime again after a long winter of being stuck indoors.  After her muscles get strong and used to walking again, the problem goes away.

When You Need To Get Help

If you begin having shin pain that does not go away as you warm up, you may be setting yourself up for injury.  Sometimes this pain will go away over time if you’re lucky, but more often the pain continues to get worse.  You notice that it hurts the whole time you’re playing your sport and maybe even after competition.  You may get your shins taped to play to try and make the pain more tolerable and you’re probably icing a lot after you play.

If this is happening to you, you probably at least have something called medial tibial stress syndrome.  This is a fancy way of saying that your shin bone, or tibia, is reacting to the stress you’re putting on it.  The muscles that attach to your shin bone pull at it every time you walk, run, jump, etc.  If the bone can’t keep up with the repairs it needs to make due to this stress, you will develop a stress reaction in the bone.  This is usually when you start noticing that the pain is hindering your performance.  This can be serious because if it is not treated properly and you continue to play with the pain, it can turn into a stress fracture.

A stress fracture is basically a hairline fracture on the bone.  If this is ignored long enough, a stress fracture can turn into a full fracture of the shin bone, or tibia.  If this happens, you’re going to miss a lot more than a week or two of play.

How Is This Treated?

If you have been experiencing shin pain that is more constant with your sport, or if you have shin pain just when you’re walking around, you should seek out a sports medicine physician and get proper treatment.  Treatment could consist of time off from your sport, using crutches, or being placed in a walking boot.  After you are pain free, you are usually allowed to start a gradual return to play program that monitors your pain as you ramp up your activity level.

Remember, if you get treatment soon, it could mean only a week or two out of competition.  If you tough it out for too long you won’t be doing yourself or your team any favors because it could mean months sitting on the sidelines!


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