19 Jul The dangers of self-diagnosing shin pain.
Shin pain is a common complaint for runners and medial tibial stress syndrome AKA ‘Shin Splints’ is often the go-to self-diagnosis. This is often followed-up by researching shin splint treatment and asking for advice from other runners on what has helped them. So, I thought it was important to write on this topic explaining other potential causes and the different presentations for each. Even though this will never be a substitute for an assessment & diagnosis from a health professional (which is a process I highly recommended), at least it will shed some light on the topic. Please comment on your shin pain experiences below.
- Shin splint symptoms: Pain is on the inner border following a line often greater than 5cm. In the early phases there will be a ‘warm-up effect’ with symptoms subsiding during the run followed by worsening pain the following day.
- DOMS: Very rare to occur in the shins but will arise the day after intense exercise. This will be located in the muscle at the front of the shin and will be tender to touch. Symptoms will subside within 24-48 hours.
- Stress Fracture: Follows a history of a sudden spike in load or general health flags which impact bone health. In the early stages of the pathology symptoms will increase steadily throughout a run & settle quickly after. Pain is described as an ache around the bone. As the pathology progresses pain is more local on the shin and will include swelling, redness and night pain.
- Compartment syndrome: Like stress fractures, this will get worse throughout a run but over a shorter period of time (often within the first 15 mins). Most cases will settle quickly if the warm-up is adequate or activity ceases. In severe cases, neurological symptoms such as pins and needles, numbness and foot drop might occur which are not present in stress fractures.
- Thrombosis conditions: More often felt in the calf but can cause an ache in the inside of the shin region. These conditions are due to a blockage in the arteries such as DVT. There might be a history of inactivity such as long flights. Pain is triggered under less strenuous circumstances such as walking and may also present as obvious swelling/redness. This is a serious medical emergency and an assessment is required ASAP.
The treatment for each of these conditions is extremely different and often unhelpful if you begin treatment for a condition that is mis-diagnosed. If you are unsure or not responding to your current treatment, a second opinion is recommended. Please share your experiences below and thanks for reading.