This study identifies the anatomical factors involved in shinsplints. The investigation was confined to the identification of select anatomical factors common to female subjects who develop shinsplints. The height of the longitudinal arch of the foot, pronation of the foot, and ratio of body weight to height was correlated with the incidence of shinsplints. Within the limits of the study, only foot pronation was significantly related to the incidence of shinsplints.Persons who engage in running activities, regardless of whether it be in recreation or competive sports, frequently experience pain in the legs. Shinsplint has been a much-used term identifying those leg pains localized about the tibia bone. Despite the frequent usage of the term shinsplint, there does not appear to be a conclusive criterion regarding application of this term. This lack of unanimity has led to the suggestion that the pain described as shinsplints results from different pathological conditions rather than one single c~n d i t i o n . '~, l4 Furthermore, the specific etiological factors involved in shinsplints seem to lack positive identification."The purpose of this study was the identification of etiological factors involved in shinsplints. The investigation was confined to the identification of select anatomical factors common to females who develop shinsplints. REVIEW OF LITERATUREShinsplints may be identified as pain along the posterior medial aspect of the tibia, particularly along the proximal two-thirds of the bone and less frequently along the distal two-thirds."~ 1 3 3 l8 The pain may also occur along the anterior lateral aspect of the tibia.13 The pain onset is usually gradual but may increase to the point of being disab~ing.~ Although pain is frequently absent during non-weight bearing, pain is elicited during weight bearing." Pain intensity increases when the person walks or runs, being most no- ticeable from midstance phase to the thrust phase of the gait pattern.' Despite the lack of pain during non-weight bearing, the areas lateral to the anterior tibia1 crest and/or posterior to the medial crest are tender to palpation.I2There is no general agreement as to the exact pathophysiology of shin splint^.^, l7 The following possibilities have been suggested as pathologi-, cal explanation^:'^'^-'^^^^^'^ 1 ) small muscle and 1 tendon tears at the periosteal attachments resulting in myofascial inflammation; 2) small tears within the muscle tissue resulting in edema and myotatic contraction; 3) subperiosteal avulsions; and 4 ) tears and irritation of the tibiofibular interosseous membrane. These explanations are speculative since no pathological evidence has been cited as verification. Walking, jumping, and running on a hard surface has been noted as a frequently occurring factor in the etiology of shin splint^.^, l3 The frequent occurrence early in training programs suggests that the physiological condition of the muscle may be a factor.I3 Opinion varies as to whether shinsplints are more common in females than male^.'^ However, ...

In order to determine the most effective method of treatment for a work-induced shoulder problem diagnosed as shoulder girdle myofascial syndrome, a comparative study of three different treatment procedures was conducted. The treatment procedures were as follows: 1) treatment with muscle relaxant and analgesic medication; 2) treatment with hydrocollator/ultrasound modalities; and 3) treatment with medication administered by iontophoresis. Results of the study indicated iontophoresis to be the most effective treatment. J Orthop Sports Phys Ther 1982;4(1):51-54.

Seven female subjects with no history of cervical trauma were subjected to intermittent cervical traction to determine the effect of angle of traction pull on upper trapezius muscle activity. The EMG of the upper trapezius muscle was recorded when a force of 30 pounds was applied at angles of 7 0 O, 25 O, and 35 O. An intermittent traction cycle of 7-second duration for each phase was used for the contract-relax sequence. Statistical analysis revealed that a positive relationship existed between an increase in angle of pull and muscle activity. J Orthop Sports Phys Ther 1980;1(4):205-209.

It was hypothesized that shinsplints are the result of muscle inflammation induced by overuse; thus, as an inflammatory response, the application of an antiinflammatory medication to the involved muscles would eliminate the pain of shinsplints. The application of hydrocortisone by iontophoresis was effective in the elimination of shinsplint pain in 18 cases of shinsplints involving four male and eight female athletes. J Orthop Sports Phys Ther 1982;3(4):183-185.

A 35-year-old female was referred to physical therapy for evaluation and treatment of a left ankle condition diagnosed as an acute sprain. The diagnosis was based in part on a patient history of mild ankle sprains. In this incidence, as in the past, the patient's family physician attributed the ankle problem to her body weight of 318 pounds in combination with the duties required of her as a janitor.The patient was questioned regarding the problem with the left ankle. The patient was most emphatic in her denial of any trauma to the ankle. Pain became evident during a 48-hour period and had persisted for 8 days before the patient was seen by a physician. The pain was localized adjacent to the left lateral malleolus. The pain was described as a dull ache when non-weight bearing, becoming more intense when weight bearing. The X-rays were evaluated by the family physician and by a consulting radiologist. Neither physician found any evidence of a bone fracture.The patient was able to ambulate but with an obvious gait abnormality. Although ankle motion was not restricted during ambulation, the stance phase of the gait cycle was less on the left leg as compared to the right. Inspection of the left foot and ankle revealed a moderate edema anterior and inferior to the malleolus. There was no