The term “shin splints” refers to pain along the shin bone (tibia) — the large bone in the front of your lower leg. Shin splints are common in runners, dancers and military recruits.
‘Shin splints’ is the common term for medial tibial stress syndrome. It refers to pain felt anywhere along the shinbone from knee to ankle. People who play sports that involve a lot of running are particularly prone to this injury. One of the most common reasons for this pain is overuse, such as trying to exercise beyond your current level of fitness.
The exact cause of the pain is unknown. It may be caused by the tendons and muscles that run the length of the shin pulling on the bone and creating inflammation. More recent research suggests it is more likely a stress reaction from the bone.
Medically known as medial tibial stress syndrome, shin splints often occur in athletes who have recently intensified or changed their training routines. The increased activity overworks the muscles, tendons and bone tissue.
Despite the fact that shin splints are very common, the exact reason why they occur is still not known; however, many of the main risk factors are now well documented.
In this article, we will look at the causes, diagnosis, and treatment of shin splints. We will also explain how to prevent them from occurring.
What Are Shin Splints?
Shin splints are pains that occur along the front of your lower leg or tibia bone.
They are a common occurrence in people who indulge in activities that involve high impact stresses on the feet and legs.
Shin splints affect a range of people, including military personnel, dancers, and runners; they often occur when training routines are changed, and the bones, tendons, and muscle tissues are overworked.
Shin splints account for an estimated 10.7 percent of injuries in male runners and 16.8 percent of injuries in female runners.
Aerobic dancers are among the worst affected and have shin splint rates of up to 22 percent.
Some athletes are tempted to run through the pain, but, in the case of shin splints, this will make the issue worse and potentially damage underlying tissues. If possible, a 2-week rest from the activity that caused the injury is recommended.
What Are Shin Splints Symptoms?
These are the most common symptoms of shin splints:
Pain felt on the front and outside of the shin. It’s first felt when the heel touches the ground during running. In time, pain becomes constant and the shin is painful to the touch.
Pain that starts on the inside of the lower leg above the ankle. Pain gets worse when standing on the toes or rolling the ankle inward. As the shin splint progresses, the pain will increase.
The symptoms of shin splints may look like other conditions or medical problems. Always talk with your healthcare provider for a diagnosis.
People with shin splints will experience some of the following symptoms:
- a dull ache in the front part of the lower leg
- pain that develops during exercise
- pain on either side of the shin bone
- muscle pain
- pain along the inner part of the lower leg
- tenderness or soreness along the inner part of the lower leg
- swelling in the lower leg (usually mild, if present)
- numbness and weakness in the feet
See your doctor if your shin splints don’t respond to common treatment methods or if you’re experiencing any of the following symptoms:
- severe pain in your shin after a fall or accident
- a shin that feels hot
- a shin that’s visibly swollen
- pain in your shins even when you’re resting
Who Is Affected By Shin Splints?
Although anyone can get shin splints, certain people have a higher chance of developing the condition. Groups with a higher risk of shin splints include:
- Runners, especially those who run on uneven surfaces or suddenly increase their running program.
- Athletes who play high-impact sports that put stress on the legs.
- People who have flat feet, high arches, or very rigid arches. In this situation, your muscles and bones may not absorb or distribute force from impact and loading activities as well.
- Members of the military and people who march or walk a lot.
- People who wear unsupportive shoes when exercising.
- Walking extreme distances.
- Anyone with underlying vitamin D deficiency, eating disorder or loss of normal menses.
- Individuals with osteopenia or osteoporosis who may already have weaker bones.
The exact mechanisms behind shin splints are not fully understood but are thought to involve a variety of different issues.
The causes, however, are relatively clear; shin splints are most commonly associated with repetitive activities that cause stress on the shinbone and the connective tissue that attaches the muscle to the bone.
It is thought that these stresses involve inflammation of the connective tissue that coats the tibia (called the periosteum); this is called periostitis.
Many experts believe that a range of tibial injuries might account for shin splints; some of these could include:
- Tendinopathy: a disease of the tendon.
- Periosteal remodeling: bone growth and regeneration.
Muscle dysfunction: some muscles may also be involved in shin splints, including:
- tibialis posterior (inside of the ankle)
- tibialis anterior (running along the shin and top of the foot)
- soleus (lower calf)
Overpronation as a cause of shin splints
Foot and ankle overpronation is also thought to be a cause of shin splints. Overpronation of the foot/ankle is when the foot steadily moves downward and toward the center of the body.
This change in position places more of the arch of the foot in constant contact with the ground. More weight is placed on the inside of the foot (medial) than the outside edge of the foot (lateral).
- The diagnosis of shin splints is usually made during physical examination. It depends upon a careful review of the patient’s history and a focused physical exam (on the examination of the shins and legs where local tenderness is noted).
- Specialized (and costly) tests (for example, bone scans) are generally only necessary if the diagnosis is unclear.
- Radiology tests, such as X-rays, bone scan, or MRI scan, can be helpful in this setting to detect stress fracture of the tibia bone.
Management And Treatment
Shin splints normally require that you take a break from certain physical activities and give your legs time to rest. The discomfort will usually resolve completely in a few hours or at most in a few days with rest and limited activity.
The suggested amount of downtime is typically about two weeks. During this time, you can engage in sports or activities that are less likely to cause additional harm to your legs. These activities include swimming or walking.
Your doctor will often suggest that you do the following:
- Keep your legs elevated.
- Use ice packs to reduce swelling. Shop for cold compresses.
- Take an over-the-counter anti-inflammatory, such as ibuprofen (Advil) or naproxen sodium (Aleve). Shop for ibuprofen and naproxen sodium.
- Wear elastic compression bandages. Shop for elastic compression bandages.
- Use a foam roller to massage your shins. Shop for foam rollers.
Check with your doctor before restarting any activities. Warming up before exercising is also a good way to make sure your legs aren’t sore.
Surgery is rarely used to treat shin splints. However, if your shin splints are causing severe pain and symptoms last for more than several months, your doctor may recommend surgery.
This surgery is known as a fasciotomy. In this procedure, your doctor will make small cuts in the fascia tissue surrounding your calf muscles. This can potentially relieve some of the pain caused by shin splints.