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This past week we examined two local cross country runners back to back with shin splints. We are treating more athletes and are witnessing more and more complex problems and are seeing the athlete go from one injury to another, many of which are caused by overuse or starting out too fast.

One of the most common injuries is shin splints, especially among beginner athletes. The term shin splint is commonly used to describe pain in the lower leg. The most common sports associated with shin splints are those that involve running, an increase in jumping or a change to a hard playing surface such as what's required in football, soccer or aerobic dance.

The condition, however, can occur in any sport and is most commonly found in the unconditioned, untrained athlete. These are two types of shin splints named for the anatornical location of the pain. The anterior shin splint is found in the front portion of the shinbone, or tibia. The posterior shin splint pain is found on the inside section of the leg along the tibia.

One of the major problwems causing the overuse injury is pronation of the foot, which is a medical term used to describe the inward rolling of the foot. It is most commonly seen in people who have flat feet or low arches. The stretching of the foot inward, places increased pull on the muscles that run along the inner border of the ankle and under the arch. These muscles originate along the inner side of the lower leg.

With the increase pounding on the arch and constant pull on the muscle, the muscle is stretched and even torn away from the bone. The result is pain and inflammation, or worse -- a tibial stress fracture. Trying to tell the difference between shin splints and a stress fracture of the shin is difficult for the average physician and nearly impossible for the layman.

Even the most experienced sports physician may have trouble diagnosing a stress fracture. An x-ray of the shin does not show all stress fractures. If you do in fact have a stress fracture, you are in for a few months of rest with no athletic activities.

Treatment of shin splints involves cause-and-effect, primarily pronation of the foot or the leg. If you are pronating excessively, orthotic devices may be helpful.

Dr. Robert Weiss lives in Westport and has a sports-podiatry practice in Darien. He is a former marathon runner and was a member of the Medical Advisory Committee of the 1984 and the 1988 Olympic Trials.