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Causes of Shin Pain

Re: Causes of shin pain

Hi Lisa,

I have been dancing for 16 years and I am now attending university for a BFA in Dance. I have been classically trained and almost a year ago I noticed a bump on the middle of my right shin. As I progressed through the year and my RAD Advanced 2 exam, it started to cause me a lot of pain. It has gradually gotten worse. It usually goes down when I don’t dance for a while, but once I jump and do a lot of work, it begins to swell and hurts more. I know that you can’t really give me a good diagnosis because you are not able to see it, but I was wondering if you have ever seen or heard of something like this. I have been to my regular doctor and got an x-ray and nothing showed up. Then I went to get an MRI exam and they said it had to do with my shin splints and that there was an abnormal mass. I am eventually going to make an appointment with a sports medicine doctor here to get another opinion because this isn’t right. If you could give me some feedback of what you think it is, that would be great! Thanks.

Sincerely,

Hannah

 

Hi Hannah

Thanks so much for your question Hannah, and I know how scary it is to have an injury that is a little in the unknown. There are several things that could be going on and I would really advise you to get a very good radiologist to read your scans and write a very clear report, and also get into see that sports medicine doctor. The very good thing is that your x-ray is clear. This means that there is no bony cyst or tumor which is very rare, but possible.

There are many causes of pain in the front of the shins including thickening of the covering of the bone (the periosteum) and muscular issues. It is very important to get a very clear diagnosis so that we know how to treat it properly, but it is also very important that we find out why it happened, so that we can fix those things so that it doesn’t recur. From this far away I cannot give you a diagnosis, but I can help to find ways to reduce the pain, to heal it, and to stop it coming back…

Did you have any traumatic incident before this started, such as getting kicked in the shins, or hitting it against a step? Bruising of the periosteum and the top surface of the bone can cause a lot of pain, that may further develop over time, especially when you are doing a lot of dancing.

Did you have a change in footwear, in your training or in the hours of training over this period of time. Sometimes if there is less shock absorption in the foot, or through the floor that you are dancing on, stress can be focused into certain points of the shin. Less shock absorption in the foot can happen if the arch is very stiff and high, or the opposite, if the ligaments are very soft and the foot is rolling in.

This can also happen if there are certain technique issues that have developed that are causing stress in one part of the shin. This can be things such as over turning and causing torsional (twisting) strain in the shin bone. It can also happen if you are carrying your weight back on your heels. If the weight is back on your heels, then the muscle at the front of the shins (Tibialis Anterior and Extensor Digitorum) are under constant strain and pull on the bone.

So I guess that my advice is definitely to get a clear diagnosis. This will help you and the doctors decide what is needed to get it to heal. Take a look at your technique, think of anything that changed around the time when it developed initially, and see if one of the doctors can help you piece it together.

I’m sorry that I can’t help much more than that, but hope that this has helped you get a little clearer on the questions that you need to be asking.

Kindest regards,

Lisa Howell

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