Shin Splints

The term “shin splints” describes pain felt along the inner edge of your shin bone. Shin splint pain concentrates in the lower leg between the knee and ankle. Your doctor may refer to the condition as medial tibial stress syndrome (MTSS).

Shin splints frequently affect people who engage in moderate to heavy physical activity. You may be more likely to develop shin splints if you participate in strenuous physical activities or stop-start sports such as tennis, racquetball, soccer, or basketball. Sometimes the pain of shin splints can be so intense that you must stop the activity.

Shin splints is a cumulative stress disorder. Repeated pounding and stress on the bones, muscles, and joints of the lower legs prevent your body from being able to naturally repair and restore itself.

What Causes Shin Splints?

The pain associated with shin splints results from excessive amounts of force on the shin bone and the tissues attaching the shin bone to the muscles surrounding it. The excessive force causes the muscles to swell and increases the pressure against the bone, leading to pain and inflammation.

Shin splints can also result from stress reactions to bone fractures. The constant pounding can cause minute cracks in the bones of the leg. The body can repair the cracks if given time to rest. However, if the body doesn’t get time to rest, the tiny cracks can result in a complete fracture or a stress fracture.

Additional causes of shin splints include:

  • an anatomical abnormality (such as flat foot syndrome)
  • muscle weakness in the thighs or buttocks
  • lack of flexibility
  • improper training techniques

Extreme force on the shins could result from:

  • running downhill
  • running on a slanted surface or uneven terrain
  • using inappropriate shoes for running or working out
  • participating in sports that have fast stops and starts

Shin splints are also more likely to occur when your leg muscles and tendons are tired. Women, people with flat feet or rigid arches, athletes, military recruits, and dancers all have an increased likelihood of developing shin splints.

Symptoms of Shin Splints

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 inflamed
  • swelling in your shin area that gets worse
  • pain in your shins even when you’re resting

How Are Shin Splints Diagnosed?

Your doctor will usually be able to diagnose shin splints during a physical exam. They’ll ask you about the types of physical activities you participate in and how often you pursue them. Doctors may prescribe diagnostic tests such as imaging scans and X-rays if they suspect that you might be suffering from bone fractures or a condition other than shin splints.

Treating Shin Splints

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
  • take an over-the-counter pain medication
  • wear elastic compression bandages

Check with your doctor before restarting any activities. It’s important to differentiate this condition from more serious conditions affecting the lower leg, such as compartment syndrome or fractures. Warming up before exercise is also a good way to make sure your legs aren’t sore.

Shin splints rarely require surgery. Compartment syndrome is a painful condition in which excessive pressure builds within a muscle compartment. If compartment syndrome happens and the pain is severe, surgery to open the fascia (the thick tissue that surrounds muscle groups) may be necessary. If a muscle tears away from your shin bone, surgery will be necessary to reattach the muscle.

Can Shin Splints Be Avoided?

Steps you can take to avoid getting shin splints include:

  • wearing shoes that fit well and offer good support
  • using shock-absorbing insoles
  • avoiding exercise on hard or slanted surfaces or uneven terrain
  • increasing exercise intensity gradually
  • warming up before exercising
  • making sure to stretch properly
  • engaging in strength training, specifically toe exercises that build calf muscles
  • not attempting to exercise through the pain
  • barefoot running

Any intensive exercise program requires strengthening of all surrounding muscle groups. Workouts should be varied to avoid overuse and trauma to any particular muscle group. You should refrain from any intense exercise program if severe muscle pain or other physical symptoms develop.

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