MRI scans for sore shins (shin splints)

From March until August this year I rode nearly 3000km on my aging Repco Superlite with clips and straps and normal running shoes. Apart from some initial teething problems with the bike setup (seat positioning), this setup, along with a relaxed (casual) approach to riding, served me well. I rode without experiencing pain on my rides or during recovery. The exception was that on longer rides I got cramps in my feet, especially my right foot.

In July, I bought some SPD shoes and pedals to see if with a stiffer soled shoe I would be able to ride without getting cramps in my feet as the cramps are quite painful. I didn’t get a chance to try out my new shoe/pedal combo until Dambusters on 22 August 2009, an 11 hour hill ride. My new shoes went well and I experienced significantly less cramping in both feet. I don’t particularly remember experiencing any pain in my shins on that ride. My next ride was Foothills Cruise on 30 August 2009. The ride went well, but 30km from the end I decided to race another ride to the end. For an hour I really focused on pushing down, pulling back, pulling up and pushing forward. I pretty much noticed straight away that my shins were hurting but I figured it was just from a lack of fitness and that I have not ridden like that before. Instead of stopping or backing off, I kept pushing through the pain and finished the last stretch in just over an hour. The next week I completed another hilly 150km ride through Jarrahdale and Pickering Brook. My shins didn’t particularly bother me on the ride, but riding into work the next week I did find they were getting sore. By Wednesday last week I quit riding. By the end of Friday last week I was in a significant amount of pain, particularly in my right shin.

I booked in for MRI scans on Monday 21 September 2009. The scans were done by SKG at St John of God Hospital in Murdoch. I arrived at 8:45, bought a parking ticket for an hour and checked in. Check in went smoothly and one of the staff called me in at my allocated time of 9:15. I was loaded into the MRI machine to scan my left knee first as it is bothering me after a crash earlier this year. Before the scan started a number of very loud alarm sounded which I found disconcerting. After that the machine started it’s scan, which was very loud. I was notified each time my bed moved and after about 6 or so scans I was set up for scanning my shins. The shin scans seemed to take a long time and I had to lay still while they were being done. Anyone who knows me knows that I am not a very calm person and not a very still person. Laying still for that long became more and more difficult. The scans went on for so long that I was convinced that my hour parking ticket must have expired. I became uncomfortable and started to get cold as it was very cold in the room. Nearing what I assumed was the end of the scans I started to get fidgety. I had really had enough and accidentally moved during a scan. A voice sounded in my headphones asking if I was still ok and informing me to keep still as there were only a couple of scans to go. Finally the scans were over and I was released. I checked my phone and realised I had been in the scanner for more than an hour! I rushed back to my car, arriving at 10:45 AM. My parking ticked expired at 9:45 AM but fortunately, no fine!

Well, after all of that I received my results today. I have been diagnosed with Tibial Stress Syndrome, more commonly known as shin splints. According to the Mayo Clinic, TSS is caused by:

training too hard, too fast or for too long.

I found an article entitled Cycling injuries of the lower extremity. The abstract for the article states:

Cycling is an increasingly popular recreational and competitive activity, and cycling-related injuries are becoming more common. Many common cycling injuries of the lower extremity are preventable. These include knee pain, patellar quadriceps tendinitis, iliotibial band syndrome, hip pain, medial tibial stress syndrome, stress fracture, compartment syndrome, numbness of the foot, and metatarsalgia.

Injury is caused by a combination of inadequate preparation, inappropriate equipment, poor technique, and overuse.

Nonsurgical management may include rest, nonsteroidal anti-inflammatory drugs, corticosteroid injection, ice, a reduction in training intensity, orthotics, night splints, and physical therapy.

Injury prevention should be the focus, with particular attention to bicycle fit and alignment, appropriate equipment, proper rider position and pedaling mechanics, and appropriate training.

Mayo Clinic adds:

It’s also important to know when to rest; at the first sign of shin pain, take a break.

So, it looks like it should be fairly easy to treat, but based on the above a proper bike fit is a priority. Also, I will back off in the future if I experience shin pain.

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One response to “MRI scans for sore shins (shin splints)

  1. Good to hear its not too bad. Shin splints are a bugger. There are actually 3 different variations(seperate injuries) that get lumped under shin splints, I have all 3.
    I do find that cycling generally doesn’t affect them too much, so hopefully with correct treatment you’ll be back to it in no time and can control it for the future. Keep us up to date on the progress and we’ll see you back on the bike in not time.

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