1. Shin Splint? Goals What is it? 3 causes? 3 treatments?

2. He was the first to do it?

3. Heaviest man to run a marathon

4. Who is Americans Best Known Marathoner?

6. Are things going bad?

8. What is a shin splint?

9. Shin Splint • Not a dx • Symptom of pain over front of tibia bone • Name given to pain over the front of the lower leg • Problems due to muscles, bone or attachments

10. Causes of shin splints?

11. Three main causes • Medial tibia stress syndrome • Stress fx • Exercise induce compartmental syndrome

12. etiology • Running downhill • Running on uneven surfaces • Weak muscles in front of leg and stronger muscles in back of leg • Waring inappropriate shoes (worn out) • Training too hard too soon

13. What is medial tibia stress syndrome

15. Medial Tibia Stress Syndrome • Due to overuse • Irritation to the tendons and attachments of the tendons to the bone (soleus, T.Posterior and FDL) • Suddenly increase their duration or intensity of training • 13% of all running injuries

16. Why are some people more susceptible to shin splints?

17. Prone to Shin Splints • Overpronation excessive forefoot pronation • Increase demand on the muscle over the front of the leg • Genu valgum • Excessive femoral anteversion • External tibia torsion

18. Physical Exam

19. Physical Exam • MTS – dull pain inside of the tibia bone 3 -12 cm above tip of medial malleolus • Small amount of swelling • Resisted plantar flexion increases the pain • Pain starts with activity and seems to disappear gets worse the longer • May feel a bump or lump

20. DDX to Stress Fx Stress – pain up and down Stress fx – pain horizontal

21. Dx tests

22. X-ray • Bone scan

23. Treatment

24. Treatment • rest • Ice • Anti-inflammatories • Arch support • ROM exercises • Neoprene sleeve • Physical therapy

25. Treatment • Cast • Fasciotomy posterior superior compartment • Deep water running • Feet orthoses • Appropriate shoes • Train on softer surfaces