DEAR DR. DONOHUE: What about shin splints? — I.J.

ANSWER: That’s a concise question. Shin splints aren’t a condition and aren’t a diagnosis. You might just as well ask about “lower leg pain.”

The shin is the surface of the tibia, the larger of the two lower leg bones. The shin is right under the skin and extends from knee to ankle.

If you don’t mind, let me make an anatomical point so that I can condense wordy descriptions into two words: medial and lateral. Medial is the side of the leg toward the center. Lateral is the part of the leg on the outside.

The causes of shin pain are numerous. It’s important to find the exact cause, since treatment and outlook differ according to the cause.

Stress fractures are one cause. They’re minute breaks in the bone like the tiny crack lines on a well-worn cup. If a person ignores stress fractures, the bone can develop a full-fledged break. Stress fractures come from overuse — too much jogging, too much running, too much leg exercise. The pain is usually on the medial side of the lower leg. Pressing on the shin with one finger locates the position of the fracture. Treatment is rest and sometimes requires crutches. It takes up to six weeks for these fractures to heal.

Compartment syndrome is another cause of shin pain. The pain is felt more on the lateral side. Leg muscles are wrapped into separate compartments with tough wrapping material. They look like stuffed sausages. Overuse is again the villain. It causes muscle swelling, and the tough outer wrapper then puts the squeeze on nerves and blood vessels. Rest again is the treatment. If pain doesn’t quickly ease, an emergency has arisen. The tough outer wrapping may have to be cut to take pressure off muscles, nerves and blood vessels.

Medial tibial stress is another cause of shin pain. It’s another overuse injury with pain on the medial side of the leg toward the back. Rest and icing are its treatment. These are only three examples. There are more.

DEAR DR. DONOHUE: My husband is 73. I am sure he’s going to die this winter. He insists on shoveling our snow, and we have lots of it. He says it’s good for him; it gives him exercise. This from a man whose other exercise consists of popping open a beer can. He comes in after he’s cleared the walk, puffing and exhausted. Please talk some sense into him. — M.L.

ANSWER: After every snowstorm, city emergency rooms fill with older men who have had a heart attack after cleaning their snow-covered walks. Snow shoveling is strenuous exercise. It burns 420 calories an hour. The heart rate of a shoveler rises to 170 beats a minute, and the systolic blood pressure (the first number of a reading) exceeds 200. Of course, the demand depends on the depth and weight of the snow. Older hearts cannot support such stress.

In addition to the work of shoveling, cold weather adds more demands on the heart.

Unless a man your husband’s age has had medical clearance for such exhausting exercise, he is tempting fate.

DEAR DR. DONOHUE: Have you ever heard of an antibiotic causing Achilles tendon rupture. It happened to me. I was given Cipro without any warning of this possible complication. How common is it? — L.H.

ANSWER: It happens, but it’s not that common.

Cipro isn’t the only antibiotic that can lead to Achilles tendon rupture. Other members of the Cipro class can do the same.

The Achilles tendon is the tendon that connects calf muscles to the back of the heel. Contraction of that muscle allows us to walk and to stand on our toes.

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.

Copy the Story Link