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There are many ways you can help children and their families get the care they need.
If your child or teen has developed shin splints, it will comfort you to know that Children’s Hospital Boston’s Orthopedic Center has a tremendous amount of experience treating this injury, developing therapies for healing and conducting research that leads to better care.
The Orthopedic Center is known for our clinical innovations, research and leadership. Ranked among the top three in orthopedics for 2012-13 by U.S. News and World Report, we provide the most advanced diagnostics and treatments, several of which were pioneered and developed by Children’s researchers and clinicians—including platelet-rich plasma (PRP) treatment for tendon repair and physeal-sparing ACL procedures for children whose growth plates are still open.
Shin splints are an overuse injury caused by repetitive stress to the muscles, tendons and/or tissues associated with the shin bone (tibia) over a period of time, without enough rest to give the leg enough time to heal.
Muscles and tendons adapt to stress—that’s how they become stronger. But they also need to rest and rebuild between the episodes of stress. With an overuse injury like shin splints, the muscle or tendon receives the stress, but never gets a chance to rest.
Consult your child’s doctor if his lower leg is painful or inflamed. Tell the doctor if your child:
• has been training very hard (usually running or aerobics)
• has changed his exercise routine
• has been running on hard surfaces
• has been running with improper footwear
Shin splints can occur if a runner or athlete:
• is experienced but is overtraining (often occurs late in the sports season)
• resumes hard training after a lay-off
• increases the duration or intensity of training too quickly
• trains on hills
• is a novice who begins training too hard before he’s conditioned
• runs on surfaces that are too hard or uneven
• runs in improper or outworn footwear
• pronates (turns his feet outward) while running
• has flat feet or fallen arches
• has poor running mechanics
• has tight muscles
Pain and/or inflammation at the side or front of the shin bone can be symptoms of shin splints. The pain tends to intensify in stages:
• At first, the injury may hurt mildly when the child plays his sport.
• As more trauma occurs, the child will experience constant pain when he’s playing.
• At the end stage, the child has constant pain in his lower leg, even when he’s not playing. At that point, the
affected area will have sustained a significant amount of damage.
Your child’s doctor will do a physical examination, and may use diagnostic tests—including x-rays, an MRI (magnetic resonance imaging) and, rarely, a bone scan—to get detailed images of the injury and rule out a stress fracture.
You and your family are key players in your child’s medical care. It’s important that you share your observations and ideas with your child’s health care provider and that you understand your provider’s recommendations.
You probably already have some ideas and questions on your mind, but it can be easy to forget the questions you wanted to ask when you’re talking to your child’s doctor. It’s often helpful to jot them down ahead of time to make sure that all your concerns have been addressed. You may also suggest to your child that she writes down questions to ask her health care provider, too. Some of the questions you may want to ask include:
• What has happened to my child’s leg, and why?
• Is this a serious injury? Will it do any permanent damage?
• What tests will you perform to diagnose my child?
• What actions might you take after you reach a diagnosis?
• Will my child be OK if he has shin splints?
• Will there be restrictions on my child’s activities? If so, for how long?
• What should we do at home?
• How can we help him understand that he needs to rest the injury?
If your child’s doctor has cleared him to go back to sports, the many benefits and life lessons he’ll gain from playing greatly outweigh the risks of injury. These benefits include:
• physical fitness
• teamwork, competitive prowess, accomplishment
• improved body composition — less risk of obesity
• reduced risk of heart disease and diabetes
• stronger immune system
• academic fitness — kids who play sports often academically outperform kids who don’t
• emotional and psychological fitness—improved self-esteem, self-concept, self-confidence, empowerment and
perception of competence
• runners and, less often, aerobics participants
• run on surfaces that are too hard or uneven
• have recently changed their training routine or started running hard up steep hills
• are using outworn footwear
• have had prior shin splints
• are not conditioned, yet are suddenly training rigorously
• have flat feet or rigid arches
• tend to pronate (turn feet outward) when running
• (to a lesser degree) aerobics participants
• (to a lesser degree) athletes whose sports involve quick cutting and side-to-side motions, such as basketball
If an overuse injury like shin splints isn’t treated and the injury continues to worsen, a stress fracture can result. Complications after proper treatment for shin splints are uncommon, but can occur. These can include:
• failure to respond to treatment
• vulnerability of the area to re-injury
Many teens who have shin splints are not only high-performing, determined athletes, but also high-performing, determined students. If you approach your rest and healing period with that same spirit of determination, you should be back to sports and your active lifestyle within a few weeks or months, depending on how severe your injury was in the first place.
The most important thing you can do to get back into your sport is to give your leg a total rest. But even though you know the importance of rest and recovery, you still could find this to be a tough time. If you feel frustrated, depressed or angry during this important time, speak to your doctor, parent or counselor—they’re all on your team, and they all want to help.
If your teen is like many young athletes who have an overuse injury, he’s not only a high-performing, determined athlete—he’s also a high-performing, determined student. Encourage him to approach his rest and recovery period with the same spirit of determination that he applies to other areas of his life. With patience and perseverance, he’ll probably be back to sports and his active lifestyle within a few weeks or months.
Even though you and your teen know the importance of resting his leg, you both might experience his healing period as a difficult time. Parents who identify with their children’s success can feel frustrated or depressed along with their children, so speak to your doctor or counselor if you need help.
Our Sports Medicine specialists advise young athletes to:
• warm up and stretch before practice
• rest at least one day a week
• cross-train/alternate sports: It’s usually unwise for a child or teen to specialize in just one sport. Multi-sport
athletes tend not to get as many overuse injuries as those who just specialize in one sport.
• alternate exercises during practice: Not only are you less likely to experience an injury—studies have also
shown that over the long term, muscle memory actually improves if you vary the drills.
• cast or walking boot: custom-made protections worn around the lower leg while shin splints heal
• cartilage: a smooth, rubbery tissue that cushions the bones at the joint, and allows the joint to move easily
• diagnosis, diagnostics: identifying disease or injury through examination, testing and observation
• ligament: elastic band of tissue connecting bone to bone
• medial-tibial stress syndrome: the medical term for shin splints
• microtrauma: a small injury to the body, such as microtears to muscle fibers, stress to the tendon, bruising
of the bone; can occur to bone, muscle, tendon or ligament. If not allowed rest in order to heal, accumulated
microtraumas can lead to overuse injuries, such as shin splints.
• MRI (magnetic resonance imaging): produces detailed images of organs and structures within the body;
shows the amount of damage from an injury
• non-surgical (non-operative) treatments: alternatives to surgery; most treatments for overuse injury are
• orthopedics: the medical specialty concerned with diagnosing, treating, rehabilitating and preventing disorders
and injuries to the spine, skeletal system and associated muscles, joints and ligaments
• orthopedist/orthopedic surgeon: a physician concerned with diagnosing, treating, rehabilitating and preventing
disorders and injuries to the spine, skeletal system and associated muscles, joints and ligaments
• osteopenia: less bone mineral density than normal, a precursor to osteoporosis
• osteoporosis: loss of bone density
• overuse injuries: sports-related microtraumas that result from repetitively using the same parts of the body, usually
by overtraining; can occur to muscle, tendon, ligament or bone
• periosteum: the thin layer of tissue that covers a bone
• physical therapy: a rehabilitative health specialty that uses therapeutic exercises and equipment to help patients
improve or regain muscle strength, mobility and other physical capabilities
• shin splints: pain and inflammation to muscles, tendons and tissue in the area of the shin bone (tibia)
• tendon: a band of tough, inelastic fibrous tissue that connects a muscle with its bony attachment
• tibia: shin bone
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”