Diagnosing and Treating Medial Tibial Stress Fractures of the Shin

Diagnosing and Treating Medial Tibial Stress Fractures of the Shin
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The tibia is the large front bone below the knee in the lower leg. It is also referred to as the shin, and general pain in this area was commonly lumped together as “shin splints.” This pain is typically felt in the medial (inside) and posterior (back) area of the leg and is therefore correctly termed medial tibial stress syndrome or fracture.

Signs and Symptoms

Medial tibial stress fractures are the most common stress fractures in athletes but symptoms are often confused for other ailments and injuries of the lower legs. The pain caused by a stress fracture is usually quite different from pain caused by other syndromes and injuries. Stress fracture pain usually builds up gradually during running, jogging, or other exercising from an irritating discomfort or numbness to a throbbing pain. Pain may also be felt when the toes or ankle are pointed downwards. Tenderness may also be felt on the bone near the area of damage, and, if severe, a hard nodule may develop on the bone at the site.

Causes

Causes of medial tibial stress fractures include running on uneven surfaces or downhill, weak muscles in the front of the lower leg in comparison to the back, over pronation of the foot (rolling the foot to the inside and flattening the arch during movement), wearing inappropriate shoes, and exercising too hard after a period of no or little activity. It is also caused by beginning high levels of physical training suddenly instead of gradually, as untrained muscles fatigue faster and lose their ability to absorb shock which is then transferred to the bone. In some case nutrients lacking in the diet may cause susceptibility to stress fractures in the tibia bone.

Diagnosis

Tibial stress fractures can be diagnosed by a doctor or podiatrist based on a physical examination and history of the patient. Diagnosis may be confirmed with an x-ray, MRI or bone scan. Doctors specializing in sports medicine commonly see this type of injury.

Treatment

Treatment for medial tibial stress fractures include rest, massaging the area with an ice compress, arch supports, anti-inflammatory medications, taping or bracing the lower leg, wearing supporting shoes, athletic training, and exercise on softer surfaces, as well as physical therapy that strengthens the front lower leg muscles, and changes in diet to strengthen bones.