The season is well under way, and by now most of you have some ache or pain that it takes a point or two to forget about, and more often than not that discomfort comes from somewhere in the "leg" region. Some of you may be familiar with your adversity, while others may attribute their ailment to shin splints. In reality a "shin splint" is a catchall phrase used to account for lower leg and shin pain and may be a more specific condition.

1. Compartment Syndrome: Where an increase in pressure in certain muscles can cause extreme pain and decreases in circulation to the leg.

2. Tendonitis/Periostitis: Abnormal strain placed on the muscles, tendons, and on the covering around the bone that the tendon is attached to.

3. Stress Fractures: When exposed to increased strain and fatigue, minute fractures may result in the bones of the lower leg.

Possible Causes

• Poor walk/run mechanics
• Inadequate calf flexibility
• Inadequate strength of the dorsi-flexors (muscles of the front of the lower leg)
• A rapid increase in mileage or frequency of aerobic classes
• Poor or worn out footwear

Treatment

1. Proper shoe selection
2. Laser/Ultrasound
3. Ice
4. Rest
5. Elevation
6. Cross training (ie.if you are in a running sport try rollerblading, cycling, swimming for your fitness to give the running muscles a break
7. Gait or Running analysis (seek help from a Physiotherapist or orthotist who has a specialized training in looking for biomechanical faults in your running technique)
8. Physiotherapy/Massage
9. After the symptoms have decreased a slow build-up of strength of the muscles of the front of the shin especially in their lengthened position is imperative for preventing a reoccurrence
10. Although a difficult muscle to stretch, the muscles can be stretched at the front of the shin by kneeling on the top of the affected foot for a 30 second hold repeating three times (see diagram). Simple ankle circles can also be very helpful for warming up the shin. Calf stretches are important to decrease the resistance to contracting for the muscles on the front of the shin.
11. Tennis requires a lot of stopping and starting and change of direction which results in rapid lengthening and shortening of the muscles and structures on the front of the shin. In the off season it is beneficial to set up a little obstacle course in your gym. It should include a variation of forward, backward, and sideways running and cutting gradually increasing speed and the duration of the work-out. This type of training requires a good warm-up and at least 48 hours recovery time between sessions

ALWAYS seek medical care within 5 days of onset if not resolving with mileage reduction, ice, and stretching.