Forearm splints are an overuse injury that causes persistent pain in individuals who engage in repetitive forearm activities. Like shin splints in the lower leg, forearm splints occur when excessive strain is placed on the muscles, tendons, and bones of the forearm. So, what are forearm splints, and what can you do about them?
Causes of Forearm Splints
Forearm splints develop due to repetitive stress on the forearm muscles. The continuous pulling of these muscles on the membrane connecting the radius and ulna can lead to inflammation and microtrauma.
Several factors contribute to the development of forearm splints. Overuse and excessive training can strain the forearm muscles, mainly when activity intensity suddenly increases. Poor biomechanics, such as incorrect wrist positioning during lifting or gripping activities, can increase stress on the forearm and lead to injury. Inadequate rest and recovery between training sessions may prevent the muscles and connective tissues from healing.
Forearm Splints Symptoms
Forearm splints typically present as a dull, aching pain along the inner or outer forearm, particularly with activity. The pain is usually localised to the muscle-bone junction. It worsens with repetitive movements such as gripping, lifting, or wrist movements. Tenderness is often present along the radius and ulna when palpated, and pain may increase with resisted wrist or finger movement, especially when gripping objects. Some individuals experience tightness or stiffness in the forearm muscles, and mild swelling or inflammation may be present in more severe cases. Symptoms usually worsen with continued activity but improve with rest.
Diagnosis of Forearm Shin Splints
A thorough clinical assessment by a sports medicine specialist is essential for an accurate diagnosis. A detailed patient history can help identify training patterns, recent workload increases, and any changes in technique or equipment that may have contributed to the injury. A physical examination will typically reveal tenderness along the forearm bones, muscle tightness, restricted range of motion, and pain with resisted wrist or finger movements.
Imaging studies may be necessary to rule out more serious conditions. X-rays are often normal in early cases but can help identify stress fractures if symptoms persist. Magnetic resonance imaging (MRI) or bone scans may be used to detect stress-related changes in the bone in cases of persistent pain.
Differential Diagnoses
Several conditions can mimic forearm splints, making it essential to differentiate them from other injuries. These include:
- Stress fractures of the radius or ulna may present similarly, particularly in athletes who engage in high-impact or repetitive activities.
- Chronic exertional compartment syndrome (CECS) is another potential cause of forearm pain. It is characterised by increased pressure within the forearm muscles, which leads to pain, numbness, and weakness.
- Flexor and extensor tendinopathy of the elbow or wrist is an overuse injury that affects the tendons of the wrist and forearm. It often presents with localised tenderness and pain with movement.
- Radial or ulnar nerve entrapment can also cause forearm pain, sometimes accompanied by numbness or tingling in the hand and fingers.
Treatment of Shin Splints in Forearm
Most cases of forearm splints can be managed with simple treatments focusing on rest, rehabilitation, and technique modification. The first step in recovery is reducing or temporarily stopping activities that aggravate symptoms. Pain management strategies, such as applying ice to the affected area after activity and using nonsteroidal anti-inflammatory drugs (NSAIDs), can help alleviate pain and inflammation.
Rehabilitation plays a crucial role in recovery. Stretching and strengthening exercises improve flexibility and restore muscle balance. Concentric and Eccentric exercises for the wrist flexors and extensors can help strengthen the forearm. Bracing or compression sleeves may provide additional support and reduce strain on the affected muscles during activity. Manual therapy, such as massage, dry needling, and myofascial release, can help relieve muscle tension and improve circulation.
More invasive treatment options may be considered if symptoms persist despite conservative management. Shockwave therapy (ESWT) has shown promise in promoting healing in chronic forearm splints. Platelet-rich plasma (PRP) therapy is another potential option, though research on its effectiveness for this condition is still emerging. Surgery is rarely required.
Other frequently asked questions about Forearm Splints
How do you distinguish between forearm splints and Chronic Exertional Compartment Syndrome (CECS)?
Athletes with CECS have pain only during activity. Generally, patients report a gradual onset of pain and swelling in the forearms with activity. With continued exertion, the pain increases. The pain is dull or aching and localised to the muscle compartment of the forearm. Rest settles the pain almost immediately.
The key to diagnosing CECS is a pre-and post-exercise examination. Generally, the pre-exercise examination is normal. However, the post-exercise examination often reveals tightness in the forearm muscles, pain when palpating the muscles, reduced sensation, and weakness in grip strength. Compartment pressure testing is the gold standard for diagnosis.
Final word from Sportdoctorlondon regarding Forearm Splints
Forearm splints are an overuse injury commonly affecting athletes who grip, pull, or lift repetitively. Early recognition and appropriate management are essential. Other causes, including bone stress, wrist or elbow tendonitis, and nerve entrapment, must be excluded. With proper activity modification, rehabilitation exercises, and technique adjustments, most cases can be successfully treated without long-term consequences.
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