Shin splints is a term used to describe pain felt along the inner edge of your shinbone. 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.
According to Claude T. Moorman, director of sports medicine at Duke University Medical Center, shin splints are more of a cumulative stress disorder than an injury. The 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 (Scientific American, 2004).
What Causes Shin Splints?
The pain associated with shin splint results from excessive amounts of force on the shinbone and the tissues that attach the shinbone to the muscles surrounding it. The muscles swell and the pressure against the bone causes pain and inflammation.
Shin splints can also be caused by 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 does not 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
- muscle weakness in the thighs or buttocks
- lack of flexibility
- improper training techniques
Extreme force on the shin 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
In addition, shin splints are 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 that can be constant
- pain on either side of the shinbone
- 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
- numbness and weakness in the feet
How Are Shin Splints Diagnosed?
Your doctor will usually be able to diagnose shin splints during a physical exam. He or she will ask you about the types of physical activities you participate in and how often you pursue them. Diagnostic tests such as imaging scans and X-rays are used only if a doctor suspects 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 two weeks. During this time, you can engage in sports or activities that are less likely to cause additional harm your legs. These activities include swimming or walking. In addition, your doctor will often suggest that you do the following:
- Keep your legs elevated.
- Use ice packs to reduce swelling.
- Take over-the-counter pain medication.
- Wear elastic compression bandages.
Check with your doctor before restarting any activities. This condition must be differentiated from more serious conditions affecting the lower leg (e.g. compartment syndromes or fractures). Warming up before exercise is also a good way to make sure your legs are not sore.
Shin splints rarely require surgery. If your condition involves compartment syndrome and the pain is severe, surgery to open the fascia (thick tissue that surrounds muscle groups) may be needed. In addition, if a muscle has been torn away from your shinbone, surgery will be needed to reattach the muscle.
Can Shin Splints Be Avoided?
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. Any intense exercise program should be curtailed if severe muscle pain or other physical symptoms develop.
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 slanged surfaces or uneven terrain
- increasing exercise intensity gradually
- warming up before exercising
- making sure to properly stretch
- engaging in strength training, specifically toe exercises that build calf muscles
- not attempting to exercise through the pain
- barefoot running
When Shin Splints Need Medical Attention
See your doctor if your shin splints are not responding to common treatment methods or if you are experiencing any of the following symptoms:
- severe pain in your shin after a fall or accident
- a shin that feels hot
- a shin that is visibly inflamed
- swelling in your shin area that gets worse
- pain in your shins even when you are resting