Does your child have leg pain?

Shin splints are a common exercise problem and sports injury, but what exactly does it mean? The medical term for shin splints is medial tibial stress. The stress occurs with the inflammation of muscles, connective tissue and bone tissue along the inner shin bone (tibia). The stress is directly related to physical activity, typically running or dancing. Moreover, any type of vigorous activity can bring about this problem, especially if starting a new fitness routine.

What causes shin splints?

The lower leg muscles and bony tissue (periosteum) become overworked and overloaded
in the shin, especially with repetitive activity. A sudden, swift change or sharp spike in duration and intensity of workout routine or a change from flat surface to hills or stairs when running can increase a child’s risk for shin splints. Flat feet, high rigid arches, rolling the foot (pronation) often contribute as well.

What are the symptoms?

The most common symptom of shin splints is pain along one or both inner leg or shin
bones (tibias). Pain may be described as sharp or dull during and after activity. Touching the tibia can cause pain or soreness. Symptoms can include night pain, swelling, muscle tightness and numbness, color change, cold foot or cause a limp; these are all red flag warning signs. A limp is often suggestive of a stress fracture. Night pain could indicate a bone injury, stress fracture, a bone lesion or tumor of the bone. Swelling of the shin can occur with a bone injury or blood clot.

Muscle tightness, numbness, color change and cool foot often indicate exertional compartment syndrome or popliteal artery entrapment.

When should your child’s shin pain be checked?

Any persistent pain not responsive to basic rest and ice for a few days should be evaluated
by a physician, especially with any red flag warning signs. A basic history and physical exam can point the doctor in the direction if tests are needed. Typically, a basic x-ray of the shin is the starting point. Other tests might be necessary during the investigation such as an MRI, ultrasound, bone scan or blood tests.

What are typical treatments for your child’s chin splints?

Once the diagnosis is confirmed, the goal is to decrease inflammation and get back
to activity. The first secret to success is rest. Shin splints result from overuse too much, too fast, too soon and from excessive uphill or stair workouts. Decreasing the impact and repetitive activity and substituting with low impact physical activity such as swimming or elliptical is a good first step. The second secret to success is correction of the root cause for the shin splints. The most common cause of shin splints are abnormal foot mechanics and postures such as high arches, low arches or a combination of both, which cause the muscles to pull abnormally on the leg bones. Therefore, inflammation and pain develop in the area.

So, first rest and at the same time make sure the pediatric athlete gets a complete
biomechanical exam and is evaluated for custom foot orthotics. While the rest will help stop the pain, if you don’t correct the mechanics with a custom orthotic, the symptoms will resume.