Shin splints, a meaningless diagnosis
DEAR DR. DONOHUE: My basketball-playing teen has sore legs. They told him at his school that it is shin splints. My husband says this is common, and that my son can play through the pain. I wonder if that’s wise. Is it? This boy never complains about anything. He is complaining about his legs. What do you say? — B.T.
ANSWER: The shin is the lower leg bone, the bone between the ankle and the knee. Its real name is the tibia. Shin splints is just another way of saying that there is pain in the region of that bone. It’s not a diagnosis.
The precise cause of shin pain ought to be determined. However, most of the causes result from overuse, and their treatment involves rest and taking anti-inflammatory medicines, like Aleve, Advil and Motrin. Moist heat to the painful area also helps. And often a change of shoes is required. The boy should definitely not “play through the pain.”
Medial tibial stress syndrome is one big cause of shin pain. Leg muscles adjacent to the shin pull on the bone’s covering, the periosteum. That inflames the periosteum and produces pain. If your son bends his foot upward and that increases the pain, that’s a sign of periosteal inflammation. People with this syndrome often have a foot that rotates too much to the big-toe side when the foot hits the ground. A change to a shoe that prevents this rolling over prevents the inflammation from redeveloping.
Stress fractures of the shin bone are another cause of shin pain. These fractures are tiny breaks in the bone. Again, this situation comes from too much use with too little rest for repair. The pain of stress fractures is usually limited to a single point on the bone. Rest is important. If the bone doesn’t have a chance to heal, a true break can result.
A third common cause of shin pain is compartmental syndrome. The muscles of the lower leg are sheathed by tight tissue, like sausage covering. Four compartments exist. Overused muscles swell. Their covering doesn’t allow for much swelling. Too much swelling compresses the muscles’ arteries and leads to leg pain. Pronounced swelling is an emergency that calls for surgical intervention.
DEAR DR. DONOHUE: Every morning when I look out the window, I see my neighbor running backward. It’s a comical sight. Is there some benefit in doing this? — P.P.
ANSWER: Backward running benefits people with heel pain. The backward runner strikes the ground with the balls of the feet rather than the heel.
It changes running mechanics and takes stress of the knees and hips.
You’d think that backward running builds muscles on the back of the thighs. It doesn’t. It exercises front thigh muscles more than the back muscles.
Running backward does present muscles and bones with a new challenge and that, in itself, is a benefit. It’s not something that people should devote themselves to exclusively.
DEAR DR. DONOHUE: Does pinching a fold of skin give you a real estimate of how much fat you’re carrying? How do you do this? — M.N.
ANSWER: It can give you a rough idea of the body’s fat percentage. With your index finger and thumb, you squeeze a fold of abdominal skin and fat. You measure the width of that fold. A quarter-inch width represents a body fat percentage of 5 percent to 9 percent; a three-quarter-inch width indicates a 13 percent to 18 percent body fat, ideal for young males.
Women take the pinch behind their upper arm. A pinch of one inch width corresponds to a body fat content of 23 to 28 percent, normal for a young woman.
This technique is hardly considered a scientific measurement of body fat.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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