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| Shin Splints and Stress Fractures |
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Q: My 14-year-old daughter is being treated for a stress fracture in her right tibia, mid shaft. She is a competitive runner, having run for 6-7 years. This is her first year in high school and they run 2.5 miles in cross country. Over the summer, her training consisted of increments in mileage to where she was running around 30 miles per week once the season started. She first began complaining of pain in the shin, but was still able to run. She ran hard for two races after her initial complaint and thereafter was unable to even jog without pain. Diagnosis : Stress Fracture.
This situation is all too common, as this condition is typically found in adolescent runners. During these prime growing years, we need to implement a better management of the biomechanics and muscular systems of our young runners. We should never wait for symptoms to move us, as symptoms are a clear indication we've pushed the envelope too far. With competition as fierce as it can be in junior and senior high school students, we should at least give these young athletes a clean bill of "structural" health before they attack the season.
Shin Splints And Stress Fractures
Shin splints and stress fractures are typically a result of repetitive motion injury in one or more supportive muscles in the lower leg. Very often, these muscles work without ever fully recovering before being asked to perform again. All athletes use similar muscles as they participate in sport specific movements, and runners are subjected to this same scenario. Unfortunately, young runners seem to have lower leg problems more frequently than older runners, probably a mere result of growing and having a musculo-skeletal system which is not yet fully developed.
Also, our sports medicine industry doesn't provide pre-season structural exams, which would pick up imbalances, structural defects or any other causative factors that influence the onset of these type conditions. All kids should be biomechanically evaluated before, during and after the season because our structures are like our fingerprints, totally unique. The only way anyone will ever know who is predisposed to injuries or who needs structural rehabilitation prior to a blowout is with this evaluation.
Biomechanical Exam
A thorough history should be taken to determine pre-existing conditions, prior traumas or any other influencing factors. The evaluation should then consist of a leg-length check, a visual exam of the athlete in the standing position (ear heights, shoulder heights, shoulder blade heights, hip heights, arm lengths, etc.) The spine should be checked for any obvious, gross curvature problems. Range of motion of the entire spine should be done to rule out fixations and abnormal motion. Pulses, respiration and blood pressure should be taken.
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