Shin splints often occur in athletes during or after exercise. Especially when jogging, there is often pulling to stabbing pain in the area of the anterior or internal tibia. Cause is usually an overload or Fehlbelastung, for example by a wrong running technique or unsuitable footwear. This can cause irritation of muscles and tendons as well as periostitis.
Pain on the tibia
In rare cases, shin splints may also be a sign of fatigue fracture or so-called tibial nerve syndrome. In the latter case, the training-related growth of the muscle leads to a constriction of nerves and blood vessels. In the worst case, damage to muscles and nerves can result. Therefore, you should always consult a doctor and clarify the cause with persistent pain in the tibia.
Overload: Common cause of shin splints
Intensive training without sufficient rest days or excessive stress after a long break in training can quickly lead to pain in the tibia in athletes. Especially when running the front tibia muscle is heavily stressed. This can lead to damage to the muscle fibers or irritation of the tendon insertions.
This manifests itself as pulling or stabbing pains on the front of the tibia during or after jogging.
Likewise, misaligned or badly cushioning running shoes can lead to a false load on the muscles and tendons and thus cause discomfort. Also, the abrupt change of the running surface - such as forest soil on asphalt - can lead to pain in the tibia.
Periostitis as a possible consequence
In some cases, overstressing may also result in periostitis. The constant change of tension and stretching of the tibial muscle during running leads to a friction between the periosteum and the tibial bone, which can permanently inflame the periosteum. In this case, the pain increases with pressure on the tibia and relax in rest periods. In addition, there is usually a swelling in the affected area.
Exclude fatigue breakage
Symptoms similar to those of periostitis may also occur in a fractured fatigue fracture (stress fracture) of the tibia. In contrast to a traumatic bone fracture manifests itself as a fatigue break due to gradual onset of pain during exercise that initially subsides at rest. Later, the symptoms persist permanently and improve only slightly, even when protected.
Fatigue fracture of the tibia is rare in healthy people and only occurs in severe, permanent overloading. However, there is an increased risk of fatigue fracture with reduced or pathologically altered bone substance, for example:
- permanent intake of cortisone
- Malnutrition or strict diets
- Vitamin D deficiency
- Menopausal women with menstrual disorders
- Hormonal dysfunction with overproduction of parathyroid hormone (hyperparathyroidism)
Shin splints: danger to muscles and nerves
Another consequence of unaccustomed, heavy stress or excessive training of the lower leg muscles may be tibial nerve syndrome (tibial ankle syndrome). The increase in volume of the tibial muscle causes the pressure to rise in a region of the lower leg defined by connective tissue envelopes. If muscle growth is so rapid that the connective tissue can not adequately adjust, blood vessels can become constricted. Then the muscle is not sufficiently supplied with blood and oxygen when it is under stress, which causes pain.
Typically, this syndrome starts after a running distance of about 500 meters and continues after the exercise. In the advanced stage, pain usually forces the patient to stop exercising. Tibia syndrome usually causes the tibia to swollen and hurts towards the knee when pressure is applied and the foot is raised. In addition, sensations such as tingling or numbness in the area of the foot can occur.
If shin splints are not treated, the lack of oxygen can, in the worst case, lead to the loss of muscle fibers or damage to nerves. Under certain circumstances, surgery may be necessary to reduce the pressure in the tissue. So, if you experience symptoms of tibial cord syndrome, stop exercising and see a doctor as soon as possible.
Many names, a problem
In professional circles, the tibiasis syndrome is also called tibialis anterior syndrome or shin splints and occasionally also serves as an umbrella term for stress-related pain in the tibia.
Osgood-Schlatter disease: Teenagers often affected
Pain in the area of the upper tibia can also cause a so-called Osgood-Schlatter disease. In this disease, bone dies in the area of the tibia where the patella ligament attaches. The exact cause of Osgood-Schlatter's disease is unclear, possibly an overload of the knee due to sports or obesity plays a role. Also, a hormonal change could contribute to the development of the disease, as often adolescents are affected in the growth phase of puberty.
What to do if pain in the tibia?
The first measure of tibia pain is: protection. Pause with your training for a few days and avoid heavy stress in everyday life. Cooling and raising the affected leg often leads to an improvement in the symptoms. Relaxing massages and light stretching exercises as well as locally acting ointments with the active ingredient diclofenac can help relieve the pain. Anti-inflammatory painkillers such as ibuprofen or diclofenac usually work very well for pain - but they should not be taken for more than a few days.
Shin splints: When to the doctor?
If the pain does not resolve after a few days or if you keep coming back, you should have the cause cleared up by a doctor. This is especially true if the symptoms occur regardless of sports or physical stress. Because in very rare cases, a bone tumor or a metastasis in the bone may be behind the pain in the tibia. Shin splints as a result of a fall or an accident are also a case for the doctor, because a trauma may lead to a fracture or hairline tear - for example on the tibialis.
Prevent by proper training
Stress-related tibia pain can be avoided by proper training. We have put together tips for you to prevent pain in the tibia:
- Train in moderation! Stop when you realize that you are reaching your limit and treat yourself to a regular rest day.
- After a long break from exercise, you should get in slowly to get the muscles back to the exercise.
- When running, prefer soft ground and avoid abrupt changes of the ground.
- When purchasing running shoes, have a treadmill analysis done to customize the shoes to your running style. You should do without shoes with spikes - they do not adequately cushion the impact when running.
- If you have misaligned feet, it may be useful to have inserts adjusted.