Shin Splints

Posted On: November 6, 2017

This is the twenty first case review from my past practice. I am Dr. David Johnson a chiropractic physician and a physical therapist in Highland Park and Lake Bluff. I am the director of North Shore Spinal and Sports Rehabilitation. I started as a chiropractor in Lake Forest, Il in 1988. I integrated physical therapy into my practice in 1990.

In the early 1990’s I was very involved with a local college basketball team. I would conduct their pre-participation physicals, which included blood work, urinalysis and an EKG. We also included a separate day of musculoskeletal screening looking at previous injuries and future preventative care. As the result of this work I saw the following patient.

The patient, a college basketball player started having bilateral shin pain (shin splints) when running and jumping. This young man was in his early twenties and he had been playing with this pain for 6 weeks. He was one of the captain’s of his club and had trained all year for the upcoming season. His pain started when his team started practicing in the fall for the upcoming basketball season.

I examined him. He had overpronation of both of his feet. He had tight calf musculature. His shins (tibia) were tender on both sides had a small tender spot about 2/3 down the leg on each. Neurologically he was fine. His lower extremity pulses were all normal.

I diagnosed bilateral tibial periostitis and was suspicious of stress fractures. X-rays were negative. I sent him for a bone scan and both tibial had a hot spot in the lower shin suggestive of stress fractures.

I advised the player to not play for 10-12 weeks. He was not happy, as he had been training for the season all year long. I told him, he had to rest or risk fracturing his tibia. He agreed.

In the mean time he was placed in physical therapy where stretched out his calf musculature, did band strengthening and made him orthotics. He was followed with serial x-rays and was released to play when he had signs of bony healing and neither shin was tender to the touch.

He went back to play that season. If the story ended there it would have been a great story. Unfortunately the next season he started having the symptoms again and not wanting to sit out his senior season he ignored the pain. He came in by the end of the season and had two metal rods placed in shins by an orthopedic surgeon as his tibia had fractured. Ouch.