People often complain about their feet sweating too much, and with half a million sweat glands in your feet it’s easy to see why. Normally, these glands excrete about a half a pint of moisture each day. Some patients sweat so bad, it can cause social anxiety and embarrassment.  The condition is known as Plantar Hyperhidrosis; it is caused by overactive sympathetic system.  So what treatments does modern medicine have for the suffering patient?
  
Topical medications:  Anti-perspirant sprays/lotions such as Arrid and Drysol are two that come to mind.  Applications would be needed once to twice a day.  How well they work depends on the severity of the condition. 
 
Oral medications: Anti-cholinergics like Robinul are found to be very effective; however, these medications could have side effects. You would need to talk with your doctor about the risks and benefits.
 
Iontophoresis:  Electrical stimulation to the feet when placed in water.  Tingling feeling can be very discomforting but it can help for several weeks.  I haven’t read any great reviews.
 
Injections: Botox! Not only helps your wrinkles but stops profuse sweating. The downfall: The treatment consists of many injections which has to be done 2-3 times per year for maintenance.

Surgery:  Lumbar Sympathectomy.  In one study, the overall satisfactory rate was 96% and 92% said they would do the procedure again.  Not too bad!

Which is right for you is dependent on the severity.  And it’s always best to start with the safest options first! Try these at home tips before seeing your doctor:

• Wash your feet daily with an antibacterial soap and dry your feet thoroughly especially between the toes. A hair dryer on a cool setting can help completely dry the feet.
• Use a foot powder daily.
• Wear moisture wicking socks!
• Use an over the counter deodorant spray daily (the kind for underarms is okay, but may not be as strong as foot antipersperants).

If you’re unhappy about your feet’s excessive sweating and at-home methods haven’t helped, give us a call to set up an appointment today!

Chi Running: Have you ever heard of it?   It’s a form of running, which claims to help you run efficiently and pain free.  It was invented by the American Ultra-marathoner Danny Dreyer, whom is also a t’ai chi practitioner.  It has several skills you must learn to make your technique correct.  The most important skills that I have read about and which make sense are to run vertically or tall, run by striking with your midfoot and not your heels, and to lean forward so you are pulled by gravity.  One great picture I found on the web gives a great image of what your form should look like.  See below – picture yourself running in a bubble:

Chi running is for anyone looking to stay or become fit. There are tips designed for beginning runners to racers and even runners nursing an injury.  Chi running teaches techniques to prevent injury and even start to enjoy running  (you read that right). These techniques  include proper posture, “body sensing,” using gravity to your advantage, and making gradual progress. For more advanced runners, Chi Running claims to teach you how to run faster with less effort.

For more about Chi Running go to www.ChiRunning.com.

When you’re not feeling quite right, what is the first thing to check? Blood pressure, heart rate and respiration? Well those are all very useful pieces of information – vital actually, but what many overlook is checking the feet! I know, we’re obsessed with feet here, but for good reason! Evaluating foot conditions can aid in the detection of diabetes, nutritional deficiencies and nerve, vascular, bone or joint issues.

Check out these 18 warning signs and what they could mean for your overall health. If you have any of these signs you should see your doctor or podiatrist today!

1. Nails with slight rounded indentations on the surface. Usually a sign of anemia (AKA iron deficiency).

2. Hairless feet and toes. A sign of poor circulation usually caused by vascular disease.

3. Frequent foot cramps. May mean a lack of calcium, potassium, or magnesium in your diet.

4. A foot sore that won’t heal. This is a major clue to diabetes and something that needs to be checked ASAP.

5. Cold feet. Could indicate a thyroid issue or poor circulation.

6. Thick, yellow or “ugly” toenails. This is the sign of a fungal infection. By the time it makes the nails “ugly” it is advanced and needs to be treated. Fungus IS contagious.

7. A suddenly inflammed, red and warm great toe. This is a sign of gout, a form of arthritis.

8. Numbness or tingling in your feet. This is a sign of damage to the peripheral nerves (peripheral neuropathy) which is usually caused by diabetes or alcohol abuse.

9. Sore toe joints. Could be an early sign of rheumatoid arthritis, usually the pain of this degenerative joint disease is first felt in the toe and finger joints.

10. Toenails with tiny holes. Psoriasis – a skin disease – can show up in the nails as many small holes.

11. Inability to flex foot upward. Called “drop foot,” this condition is the sign of muscle or nerve damage somewhere in the body.

12. Dry, flaky skin. Athlete’s Foot, a fungal infection, usually starts as dry, flaky, itchy skin before progressing into blisters and inflammation. Again, fungus IS contagious.

13. Patriotic toes. If your feet change color from white to blue to red and back to a natural color in the winter or when they’re cold you may have Raynaud’s Syndrome. The color changing is caused by blood vessel vasospasms (over compensating) due to temperature.

14. Painful feet! Could be a stress fracture and a sign of a underlying issue such as osteopenia, poor vitamin D or calcium absorption, or malnutrition. It is not uncommon for patients to walk on broken bones, but it is painful!

15. Swollen tips of toes or fingers. Called “digital clubbing,” this is a common sign of a serious lung disease as well as a sign of heart or gastrointestinal disease. See your doctor right away if you think you have this symptom.

16. Shooting pain in heel. This usually means plantar fasciitis, which is inflammation of the fascia (connective tissue) that runs along the bottom of the foot.

17. Stinky feet. Though smelly feet generally doesn’t mean much it could be another sign of a fungal or unseen infection or ulcer. Bacteria feasting on your sweat and dead skin cells is what causes the smell. Your best bet: keep your feet clean and DRY!

18. Old or improper shoes. Though not a warning sign, it is the root cause of many foot issues from deformities to strains and other foot pains. Old shoes lack support. Running shoes should be replaced about every 350 to 500 miles. Diabetic patients should be especially attentive to their shoes, not to mention the feet inside of them!

You are the best judge of your overall health, you know when you aren’t feeling quite ‘right,’ and you’re the only one who really knows what you feel. If you have any of these signs you’re best bet is to be checked out by a doctor.

Remember, your feet shouldn’t hurt!…or change colors, or itch, or swell…

Call Shenandoah Podiatry at (540) 808-4343 to schedule an appointment today.

Full article

Stretching: What’s the best way? Whether you are stretching  just to feel good or you are nursing an injury, here are the three types of stretching exercises. 
     

Ballistic stretching is a repetitive rapid application of force, better thought of as the ‘bouncing or jerking’ stretch.  Out of all three, research finds this mode of stretching the worst.  It can actually increase your risk of injury.

Passive stretching is the when you use a partner or a therapist to aid in applying force to stretch muscle groups.  This type of stretch in a good thing to do, but only in a controlled enviroment, such as a training room or a physical therapy office. Why?  There has to be good communication between you and your partner. Slow and sensitive application of force is needed and you don’t want someone pushing too hard. 

 

Static stretching is a when a steady force is applied to the muscle for 15 to 60 seconds.  This is the most popular, the easiest, and the safest of all three.  It’s even reported to decrease muscle soreness after you exercise.

There’s a question that we get here in the office quite frequently – and that is “Why is it that your diabetic patients require special shoes?”

To understand the answer to this question, one must first understand the diabetic foot. One big reason why it is important for any diabetic person to carefully monitor and control blood glucose levels is that when uncontrolled, many complications can arise. Some complications that are frequently seen in our office are nerve damage, decreased blood flow, and foot and joint problems. All of these problems can and do affect the feet.

Besides the bladder, bowel and stomach issues that can arise from diabetic neuropathy, poor sensation can have devastating effects on a patient’s feet without proper care and attention. Inability to feel pain, pressure or temperature can easily allow for rubs, blisters, burns and other injuries to go unnoticed.

Feet are sensitive and the blood supplying oxygen to the lower extremities may be reduced without you even being aware of it. The decreased oxygen delivery to the feet from poor circulation results in slower healing and nail growth.

Uncontrolled blood glucose levels can be inherently dangerous. “Rollercoaster” blood sugar levels can damage tissues and cells. An elevated blood glucose level can cause dehydration and dryness of the skin as well as promote the growth of bacteria and fungi (since sugars are a good food source for these organisms). Because of this, bladder, gum, and skin infections are common in our diabetic patients with high sugar levels.

So, Why Special Shoes?

• Proper shoes are the first line of defense against injury and infection.
• Well fitting shoes are comfortable and allow proper circulation in the feet.
• Proper shoes will allow your feet to breath while still protecting them.
• Proper shoes can prevent the development of ulcers, blisters and fungus.

How are the shoes different?

• Deeper and wider to accommodate diabetic inserts, allow more room for feet, and reduce possible pressure points.
• These shoes provide excellent support which is recommended for anyone buying shoes.
• Most have a breathable fabric upper to promote good air circulation within the shoe.
• Most are custom ordered for size and width.
• The toe boxes are roomier to prevent pinching or squeezing the toes as well as to allow for more room for foot deformities.
• Many are easily adjustable or have elastic which makes it easier to put on without making the shoe too tight or too loose.
• Available with Velcro to make putting on shoes easier for patients with peripheral neuropathy who can not feel their fingers well enough to lace shoes.

While us commoners might not have heel pain from Mr. Choo, Vuitton or Blahnik, but we still wear our beloved 4-inch stilettos (maybe they’re Steve Maddens or Sam Edelmans…) When our heels, however, constrict our foot, we are bound to have increased foot pain ranging from hammertoes or “simply” bunions, corns or calluses. That’s not going to keep us from wearing those shoes on our weekend nights or working girl days, so what precautions can we take to prevent us from wanting to take them off 15 minutes after we put them on?

• Make sure the shoe fits- yes, you might encounter a deal that’s too good to pass up at T.J. Maxx but if you only wind up wearing them for half the night because they’re too tight, they will only take up valuable closet space!
• Where does it hurt? – If your entire foot endures pain, get a shoe length cushion insole, or if its just the balls of your feet, purchase silicone metatarsal pads
• Thicker heels- we’re in luck ladies, the thick heel is on it’s way back! This helps relieve some pressure from the foot rather than the pin needle heels
• Gradual slope- do most of your heels look like you’re going to fall face-forward when you stand in them? Try looking for cute heels that have a gradual slope instead to alleviate some pressure on the ball of the foot
• Open-toe heels- this style might not always be possible, but again panty hose with open toe heels is back (dark tights + dark heels). Open-toe heels help reduce corns and calluses which should be removed by a podiatrist

As a parent, children with any developmental problem can cause panic and anxiety. However, Pigeon-toed is a common orthopedic problem in children, and usually corrects itself in a couple years.  Pigeon-toed, or in toeing, is when the feet turn inward instead of pointing straight ahead. Feet also can have a problem of out toeing, where the feet point side to side instead of straight forward.

Some facts of in toeing are:

• The most common overall cause of in toeing is tibial torsion, which usually becomes apparent when infants begin to walk
• Almost always presents symmetrically
• In toeing is significantly more common than out toeing and occurs in about 2 out of every 1000 children

Common causes of in toeing:

If your child feels pain, discomfort, swelling, or limping then it is best to be evaluated by a podiatrist.

 See more common ailments of child feet here.

Read this article I have found.  Even after years of medicine becoming more in-depth, we still are just scratching the surface of what is called FASCIA.  Some even believe it to be an organ. Either way, tight fascia is the root cause of heel pain in your feet and other nagging injuries.  If you have any questions, please leave a reply.

“Understanding Your Fascia” Article

Is your New Years resolution to get fit by going to the gym? If so, then there are a few things you should know about keeping your feet safe at the gym.

First, always start new workout routines slowly and gradually increase the length of your workout. This will also build your stamina and prevent overuse injuries such as stress fractures, tendon strains and sprains. Always remember to stretch thoroughly before and after any workout. If there is any evidence of an ankle sprain or tendon strain, seek an appointment with your podiatrist or foot and ankle surgeon right away. Untreated or multiple ankle sprains can lead to chronic ankle instability.

Second, wear proper shoes and socks designed for exercise or sport. Shoes should support the arch of the foot and provide cushion for the heel. Not only do the shoes need to support, but they must also be properly fitted. Too tight shoes may cause a neuroma, loose shoes can rub and irritate the skin. Socks are best when they are cotton or non-slip, which help prevent blisters. 

Third, use good technique when exercising by using proper posture and by using equipment correctly. Not doing this can result in instability of the foot and ankle. Not to mention correct use of equipment can bring more desirable results and help keep that motivation going!

Lastly, make sure to protect yourself from bacteria, viruses and fungi. Gyms are sweaty public places where microbes love to breed. NEVER go barefoot, always clean the equipment before and after each use (a lot of gyms will provide disinfectant or sanitizing solution to clean equipment with) and cover up any cuts or open wounds.

The most important tip is to listen to your body. If something is not right or you are having pain, call your podiatrist’s office for an appointment. You do not want to start the New Year off with an injury!

With 26 bones in each of your feet, it’s hard to say no to that question; but, what I’m really talking about are extra bones in the feet also known as accessory ossicles which are present at birth in a small portion of the population. These extra bones are not required for normal foot function and can occur in a variety of places. Two common occurrences of extra bones manifest as accessory navicular syndrome and os trigonum syndrome. Some patients with accessory ossicles don’t even know that they are there until the foot is x-rayed, others may feel varying levels of pain and discomfort.

Accessory navicular syndrome can result from injury or trauma, chronic irritation rubbing  on the extra bone, or excess activity or overuse. Symptoms commonly appear in adolescence and can include a visible bony protrusion that can be red or swollen and pain or throbbing in the mid-foot and arch. The posterior tibial tendon may also be irritated since it is located near the accessory navicular.

Treatment for accessory navicular syndrome can be surgical or non-surgical. Your doctor my begin treatment by trying non-surgical measures such as immobilizing the foot in a cast or boot, ice, NSAIDs, oral or injected steroids, physical therapy, or custom orthotics.

Surgery may be required if non-surgical treatments fail and involves removing the extra bone and possibly reshaping the posterior tibial tendon to improve its function.

Os trigonum syndrome can also be triggered by an injury but can be caused by frequent pointing of toes as in dancers, soccer players and other athletes. Pointing the toes can result in crunching the os trigonum between the heel and ankle bones causing pain and inflammation. A deep aching pain may be felt in the back of the ankle while pushing off that foot when walking or pointing the toes downward. Tenderness and swelling are also frequent symptoms.

Non-surgical treatment for os trigonum syndrome can include rest, immobilization, ice, NSAIDs, and/or a steroid injection. Surgical treatment would be discussed if non-surgical treatments do not relieve symptoms and involves removal of the os trigonum.

To diagnose your ‘extra bony feet’, the doctor will examine the foot, ask questions about the development of your pain and take x-rays. Other imaging tests may be ordered to rule out alternate diagnoses.

If you think you have either of these conditions or if you’re feeling any discomfort in your foot or ankle, it is best to seek treatment to ensure that you stay happy; because when your feet hurt, you hurt all over!

Would you like to hear the good news first or the bad?

The Bad News: I have to hang up my minimalist running shoes for a bit.  Unfortunately, the hip I injured training for the Pittsburgh Marathon is still plaguing me!  However, I will be having some therapy soon and hope to be back to running and continuing my journey using Stem Footwear minimalist running shoes!!! 

The Good News: In the meantime, check out this recent article published for The Blue Ridge Outdoors Top 40 running shoes.  Stem Footwear is number 16 and has a great review.  Not bad for a new company competing against established companies like Nike!

Twenty eight year old Kenyan native and student at the University of Alaska Anchorage, Marko Cheseto, was found on Wednesday November 9th after being missing since the evening of Sunday the 6th. Cheseto reportedly went missing on Sunday due to a “personal crisis” without wearing gloves or a hat just with running shoes, jeans and a light jacket. It snowed more than a foot while he was missing and the temperatures dropped to the single digits. The six time All American runner was admitted to the hospital after being found on Sunday with severe hypothermia and frostbite – his shoes were actually frozen to his feet. Unfortunately, both of the runner’s feet had to be amputated above the ankles.

Read more about this inspiring story here.

I’ve only been a podiatrist for about four years now, but it’s easy to see why Diabetes is a silent killer.  It amazes me the lack of knowledge most diabetics have about their disease and even what medications they take.  Honestly, it is sad.  As a physician, it is my duty to educate every diabetic about the potential harm they could face due to their lack of control and awareness of their disease.

Depression, I believe along with denial are the two obstacles physicians face with our diabetic patients.  Usually these two problems, depression and denial, are carried on the backs of the poorest controlled diabetics.  I encourage all people with diabetes to take an active step today and everyday about treating their disease and the problems associated.  It’s not something to hide or be ashamed of; it’s common and it’s a killer.

Fight back against it!  Ask yourself if there is more you or your physician can do for yourself to get you exercising, get you motivated, and get you happy. Please,  don’t let your denial and depression of this disease be your obstacle.

-Dr. Kate

To learn more about diabetes, how to manage your disease, how to get exercise and even to get some recipes go to the American Diabetes Association website.

A big, common problem that we see in our office today is dry, cracked heels. One reason that this problem occurs is from the amount of pressure applied when standing or walking, which makes the bottom of the feet expand sideways. Cracking can occur if the foot is not flexible enough. Cracked heels are linear cut wounds that affect the epidermis layer of the skin, or the surface layer of the heel. If the cracks expand beyond this layer, bleeding, pain, and infection may occur.

Pressure is not the only reason that people have cracked heels, a dietary deficiency or a lack of proper foot care can also be reasons. Zinc and Omega-3 fatty oils are the big contributors to dry skin if they are lacked in the diet. To get more Zinc in your diet, without supplements, you can eat foods such as oysters, organic chicken, crab, kidney beans, yogurt, and brown rice. For Omega-3 fatty oils, cold water fish or flax seed oil are good choices.  Some other vitamins that are important are Calcium, Iron, and Vitamin E, along with Magnesium to ensure proper absorption of calcium.

To prevent cracked heels, you should do the following:

• Keep your feet clean and dirt free!
• Exercise your feet regularly.
• Make it a daily habit to cleanse and moisturize your feet.
• Gently exfoliate your feet when needed (should only be necessary once or twice a week)
• Alternate between hot and cold water for your foot bath to soothe the feet.
• If you have deep, bleeding, cracks don’t walk barefoot until the cracks are healed and gone.

If you already have dry and cracked heels, here are some home remedies to help hydrate:

• Apply, substantially, one or more oils/moisturizers such as almond, grape-seed oil, olive oil, lanolin, cocoa butter, shea butter, or coconut oil to the heels and feet. Then put on a pair of thick cotton socks and wear over night to allow the skin to soak it all up.
• Mash a piece of papaya and use it like a masque on your heels. A pineapple can also be used but might be a little more difficult.
• Mix one cup of honey for every two cups of milk into a large bowl that is big enough to fit both of your feet for a foot bath. Soak your feet for 15 minutes, while lightly massaging the mixture into the skin. Rinse off with lukewarm water.
• Beeswax is another great resource for dry/cracked skin. Find a product that has a high proportion of beeswax; to find this, look at the ingredient list and beeswax should be listed closest to the beginning of the list.
• Apply the pulp of a ripe banana on the dry/cracked heel and let is sit for ten minutes, then rinse clean. Do this at least once daily, consistently.
• Soak your feet in lemon juice for ten minutes daily as needed.
• Apply a mixture of glycerin and rosewater on a regular basis.

If you are continuously fighting dry/cracked heels with little relief and live in the Blacksburg, Christiansburg or New River Valley area, please call to schedule an appointment with Dr. Feeny or Dr. Kate today!

A young Dr. Kate running in a cross country meet.

I went on a walk/jog with Stem Footwear shoes yesterday and did ok.  It was 14 years ago, I won the Pennsylvania State Cross Country Championship as an individual!  I had to at least celebrate in some way.  Can’t believe it…14 years!  Man, I feel old.  Anyway, my feet are not as achy and sore but I’m definitely still getting use to the pounding and different approach of foot striking. 

I did a run this morning with Alison, our office secretary in Troutville, who wears Vibrams.  Decided to jump back into Mizuno running shoes with my custom orthotics to see if  I would be more comfortable. Result?  My feet felt worse!  Since doing most daily activities in flat shoes and my Stem Footwear shoes, my feet are adapting more and any subtle change is very noticable.

Be sure to check back next week for more updates on my barefoot adventure!

For some people out there checking winter boots for creepy critters is a habbit that can’t be broken. Generally though, people will just slip on their everyday shoes without hesitation, but your dark, cozy shoe is definitely a good place for critters to hide. Dr. Kate found out first hand this week why you might want to start checking all your shoes before putting them on.

This spider was found in Dr. Kate’s running shoes right out of her gym bag. This spider is VERY likely a female Black Widow spider (note the red hourglass on her belly). The black widow’s neurotoxic venom can be deadly if left untreated, although survival rate is quite high if treatment is sought.

Spiders and other insects are seeking shelter as the weather gets cold; so, remember to keep an eye out for spiders camping out in your shoes, even those that you wear regularly.

So I am embarking on a journey using STEM FOOTWEAR’S shoe line, to see how I do in a barefoot running/minimalist running shoe.  Also, to see if it’s a good idea for the general running public.  This was my first week trying the product. Here’s what I have uncovered so far…

PROs:

• I absolutely love walking in these shoes.  Whether a walk for exercise or just to wear in the office, they feel like wearing a house slipper. I feel light on my feet and not suffocated by a bulky shoe.
• No more nerve pain on the top of my foot! Why? No orthotic pushing my foot up under my tight laces. Yea!
• Achilles tendon gaining some length.  Hurts so good! From wearing an orthotic in my running shoes, which already happens to have a heel, I have done some major tightening to my calve muscles and Achilles tendon. Too much for sure.  Feels nice to let my legs stretch out.
• ATTENTION to people with bunions.  Stem Footwear has a great shoe with plenty of toe room in every direction.  The material of the shoe is flexible so it will also mold to your deformity.
• Mini-arch support.  Since the shoe has a flexible rubber sole, you tie the shoe and Vallejua! A shoe providing  arch support.

CONs:

• Not for the hasty runner.  I thought 15 minutes of a jog on pavement wouldn’t be so bad but being my first time, I should have opted for 5 or 10 minutes and on a grass surface.  I felt great during the jog, but after, I would compare how I felt to how someone feels walking on the hard floors of a mall all day!  I was exhausted.
• Watch out for stones!  My feet are still really weak and sensitive to anything but a flat surface, especially in a “barefoot” type of shoe.  I know this will take some time to  ’desensitize’ my feet.

Otherwise, a great week!!

What are orthotics and what do they do?
Custom-made foot supports that are worn under your heel and the arch of your foot are referred to as orthotics. These devices are molded to be anatomically matched to your foot and they do more than just provide support.  Orthotics are designed to realign your foot to a neutral or natural position to alleviate pain in your feet, legs and back as well as to restore balance, improve sports performance, and relieve foot fatigue.

Research shows that the majority of foot problems can be directly connected to skeletal imbalance. More people tend to have some amount of either hyperpronation (flat feet) or hypersupination (high arches). The presence of these conditions can cause the foot to be unstable during normal everyday activity. This constant stress on the feet can lead to pain in the feet, ankles, legs, knees, hips, and back. Orthotics can improve function in the foot by compensating for existing imbalances and in most cases can relieve or prevent the associated pains.

How do you know if the use of orthotics is right for you?
If you have an obvious imbalance that causes such symptoms as flat feet or high arches, or if you have external misalignments such as “knock knees”, or “bow knees”, in-toeing, or out-toeing you are probably a good candidate for orthotics. If you participate in an activity that places stress on your feet of if your work requires you to be on your feet for extended periods, orthotics could be beneficial. The use of orthotics is just one of the conservative foot treatments used in our offices. They can be used to treat foot, heel and arch pain, some calluses, diabetic ulcers and pressure sores, arthritis, abnormal foot function, and to prevent sports injuries or improve sports function. Orthotics can be used to treat children as well as adults. The best way to find out if orthotics can help you is to make an appointment with us for an exam.

How does it work?
When custom molded orthotics are needed, we utilize the Xtremityscan™ – Digital Acquisition System for accurate capture of your foot shape. The scan transfers information about your feet and how they function into digital form. With this system, we can see biomechanical weaknesses that are causing your symptoms. Your digital analysis and a prescription, completed by Dr. Feeny or Dr. Steklachich, are then sent electronically to a lab for fabrication of the orthotics. We are so confident in this system that it comes with Dr. Feeny’s Personal 100% Money Back Guarantee if you are not completely happy with your new orthotics. Dr Feeny only wants you to keep the orthotics if you are completely comfortable with them. And she is so sure that you will be, she is willing to guarantee it!

Shin splints is a very common problem among athletes.  It’s defined as pain and inflammation along the lower leg bone.  It either presents on the inside or front of the tibia bone. It’s unknown what causes shin splints, but common ideas involve rigorous, repetitive activity, flatfeet and high arched feet, and muscle group imbalances.  Typical symptoms are pain and burning along the bone with activity, but are relieved with rest.  There can even be tenderness along the bone.

This is also a common symptom and presentation of a stress fracture occurring in the tibia.  A stress fracture, however, is a small crack in the bone, not always seen on x-ray.  If left untreated, a stress fracture can result in a full break of the effected bone.

Beside home therapies, including NSAIDs (non-steroid anti-inflammatories), RICE therapy (rest, ice, compression, elevation), changes in shoes, using orthotics, or changing your activity level, a bone scan or MRI might be warranted to rule out a possible fracture.

Both imaging modalities are far superior to radiographs in a doctor’s office and can make the correct diagnosis. Both images will help contrast one injury from the other based on the area of involvement.  A bone scan will be lit up along the bone if its shin splints or be a very focal area of contrast if a stress fracture.  The same holds true for an MRI.

So if you are having shin pain and all conservative treatment has not helped, make sure you look into these tests to help you get back to your activities.

Try freezing water in small paper cups to ice your shins. Tear away the cup as the ice melts.

Watch at 1:35 to see why NOT to ignore shin pain…