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Dear all,

Just a quick question I have been reading about shin splints and tibial overuse injuries.Is shin splints,tibial fasciitis and medial tibial stress syndrome all the same
condition?

Also,how would you diagnose shin splints?

Thank you for any comments.

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Nikki,

Shin splints is not a diagnosis. Start with this thread: Medial Tibial Stress Syndrome

Ian

Shin splints is an umbrella term for three main conditions (as I understand it):

1) Tibial Stress Fracture.
2) Compartment syndrome
3) Tibial fasciitis/medial tibial stress syndrome/periosteitis (all same thing as I can gather)

I had a lecturer that used to throw things at us if we said shin splints in his lecture.

Hi Sam,

Thanks for the clarification,I have a lecturer that throws things at us too if we say 'too many toes sign' instead of using the actual term!

might be the same lecturer.. where are you studying?

UEL in Stratford.

hehe.. yeah its the same guy. Tell him I said hi.

But you can use too many toes sign if the patient has polydactyli.

Wow,dats so strange! Yeah I will but I am graduating soon,have finals next week.

Yeah dat is the correct term that you have used,forgot about that.

Somebody give him (or her) a good kicking, they might grow up then.

__________________
Who? What? When? Why? Yeah? And? So? What?

"My mission drive is to open up my eyes, 'cause the wicked lies and all the sh!te you say..." http://www.youtube.com/watch?v=V4NW5S1UTPQ

"Science is the antidote to the poison of enthusiasm and superstition."

Unfortunately we can't do that.

If it is with regards lectures, just remember your basics, eitiology, pathology, clinical signs and symptoms and treatment regimes.
Also it's all about the jargon, common term as heard in the private clinics would be shin splints as is 'flat foot'.
As a health professional it is our diagnosis that then allows the correct pathology to be determined. This can range from inflamation of the deep flexor tendons as they emerge at the lower third of the medial aspect of the tibia before entering the flexor tunnel through to stress fracture of the upper third of the tibial.
Remember the basics and good luck in the lectures.

Hi Alex,

Thank you for your feedback.I actually need this information for my final exam which is in two days time.The focus of the exam is on diagnosing shin splints as a condition but I have gathered from everyone's feedback that its not an actual condition/diagnosis,rather it is a bit like metatarsalgia.

I can't believe you still being taught it! I think the only time our students get exposed to 'shin splints' as a term is in the history lesson at the start of the MTSS lecture...

__________________
Craig Payne
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Well Craig the problem is, these terms are taught!
As a private practioner for 22 yrs I am frustrated that the general public have been taught by 'New Idea' journals (health and woman's magazines) and so the students need to be aware of the terminology.
I totally agree with you, we as a profesion should not be teaching such generalize terms. I still shudder when I hear reference to 'flat foot, metatarsalgia" and the like.

It is important that the term is still taught, as you said the lay press still use it and they will come across it. I like to think we teach the term in the appropriate context (ie a history lesson).

__________________
Craig Payne
__________________________________________________ ___________________________________
Follow me on Twitter | Run Junkie
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

If it is for your final exams then remember:
Diagnosis is determining the 'mechanism' of pathology and ruling out differential diagnosis'.
Is it local, systemic, skeletal? Is it caused by structure or function?
Good luck, if you have got to your finals don't get stressed, you are almost there.

Hi Alex,

Thank you very much for the encouragement and advice.

I have to say that although we are thought shin splints as a condition,we still have to discuss
the etilogical factors underling the symptoms of shin splints.

Nikki, good luck with your finals. I'm sure you'll do OK!

To clarify other points, I also remember that we were taught the term shin splints and then pretty quickly were encouraged never to use it again. I think it is, as Nikki has already pointed out, as useful a diagnosis as metatarsalgia.

In my orthotic lab I still frequently see shin splints written as the chief complaint.

Same wrote:
Although shin splints is a lay term just as high blood pressure is to hypertension, isn't it important to teach the implication of the term. So can medial tibial stress syndrome and shin splints be used interchangeably when I read it as the chief complaint on the Rx? As I understand it, both are collective terms to describe a set of symptoms that could have a number of etiologies with one being a more proper medical term to describe it. Correct?

Respectfully,
Jeff

Hi Jeff,

Yeah I agree the medial tibial stress syndrome is a better term as it is more specific to the actual location of the symptom.
Also,what clinical tests would be useful for tibial fasciitis?Would MRI show inflammation as its associated with inflammation of the tibail fascia?Bone scans?

Thanks

Hi Jeff..

I agree that Shin splints can be used to describe the symptoms that a patient is experiencing, but I feel that it is a descriptive term rather than a diagnosis. High blood pressure and hypertensions are two ways of describing high blood pressure. I think the use of "shin splints" would be more like having an umbrella term indication that you have something wrong with the vascular system, but it could be high blood pressue, low blood pressure or high cholesterol.

I have always been pushed fairly strongly by my lecturers and seniors to try not to use terms like shin splints as it is not a diagnosis. Much the same as pes planus is not a pathology, but is often used as a diagnosis in referrals I see.

Nikki, I think you can diagnose tibial fasciitis clinically. Generally it is of gradual and insidious onset, typically presents with pain on palpation along the distal third of the medial aspect of the tibia, tends not to be no obvious focal tenderness. I believe that one of the aetiologies is thought to be increased eccentric firing of the muscles connected to that part of the shin, so look for biomechanical abnormalities, excessive pronation, poor footwear etc. Could consider diagnostic imaging to rule out stress fracture, but not really indicated for tibial fasciitis.

Kindest regards,

Sam

Goodluck with the exams Nikki and when you get time maybe these might stick out to as quite strange from the lecturer, you can´t use the term too many toes sign you must use the actual term or get stuff thrown at you, but you use "Shin Splints" seems very strange to me.

I put shin splints in the layman Diagnosis section, patients use the term kind of understand what it means, it´s your job ( in the future ie a fews days ) to identfy the tissue under stress and the construct a treatment plan to reduce the loads and help the tissue heal (if possible), it also very important that you communicate with the patients so they understand what the problems is, in terms that they understand.

Anyway goodluck with exams

__________________
Mike Weber.



Crazy Mary

Dear Sam and Michael thank you for your feedback and support.