Shin Splints During the last several decades, pa

During the last several decades, participation in sports and exercise has increased dramatically both in the United States and abroad. For the most part, such emphasis on physical fitness is of positive consequence. However, athletics' increased has resulted in a virtual epidemic of overuse injuries. Perhaps the most common such syndrome consists of shin splints. At the present time, this disorder is incompletely understood.

It has been estimated that approximately 59% of Americans participate in some type of competitive or recreational athletic activity (6:301). According to Orava and Puranen (1979) shin splints account for 60% of all lesions causing pain in athletes' legs. Moreover, shin splints additionally represent about 10-15% of all running injuries (Gudas, 1980; James et al., 1978). Despite the prevalence of this medical problem, however, only one prospective study on shin splints has been undertaken: Andrish and colleagues examined a U.S. Naval Academy cohort of 2,777 cadets engaged in basic physical education training. Of this group, 97 suffered shin splints; the reported an incidence for the lesion was 4.07% (1:133).

Considerable ambiguity surrounds this particular pathologic condition. Perhaps such uncertainty is reflected in the variety of different labels applied to the disorder. For example, shin splints may also be known as posterior tibial tendinitis, anterior (or medial) shin splints, soleus syndrome, and tibial periostitis

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igorous exertion (e.g., during preseason training) (3:203). The physical examination may reveal tenderness along the medial border of the distal tibia. In addition, there may also be tenderness over the anterior tibial musculature. Pain can sometimes be elicited by dorsiflexion or plantar flexion of the foot against manual resistance. In the more severe cases, mild induration and swelling can be observed (3:203). The shin splints diagnosis should generally be limited to musculotendinous inflammation. It should exclude stress fracture or any ischemic disorder. Certain studies have suggested that pain radiating down the foot does not represent shin splints. Puranen (1974) and Nutig (1981) both associated this symptom with neural compression caused by muscle compartment pressure. In cases which prove refractory to initial conservative therapy various clinical studies may be appropriate. Although, shin splints patients typically have normal radiographic findings, such analyses might reveal other problems (e.g., occult fractures, stress fracture, or tumor). Serial radiographic studies can be employed for patients with progressive symptoms. Secondly, shin splints also have a unique scintigraphic appearance on bone scan. Rad

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