Shin Splints

What are shin splints?

Shin splints are pain along the tibia (shin bone), which is the large bone in the front of your lower leg.  The medical term is known as medial tibial stress syndrome. This pain is common in runners, dancers and military recruits.  Shin splints commonly occur in athletes who have recently increased or changed their training routines.  The increased activity overworks the muscles, tendons and bone tissue. 

What causes shin splints?

Shin splints develop when the muscle and bone tissue in the leg become overworked due to repetitive activity.  Shin splints often occur after sudden changes in physical activity such as increasing the number of days you exercise each week and changes in duration and intensity, such as running longer distances or on hills.  Other factors that contribute to shin splints include having flatfeet or abnormally rigid arches as well as exercising in improper or worn out shoes.  Runners are at high risk for developing shin splints as are dancers and military recruits.

What are symptoms of shin splints?

The most common symptom of shin splints is pain along the border of the tibia as well as swelling.  The pain may be described as sharp and razor-like or dull and throbbing .  There is pain during and after exercise and can be aggravated by touching the sore spot. 

Diagnosis of shin splints

Shin splints are usually diagnosed based on your medical history and a physical exam.  An X-ray or other imaging study can help identify other possible causes for your pain such as stress fractures, tendinitis, and chronic exertional compartment syndrome.  If your shin splints are not responsive to treatment, Dr. Fihman will want to make sure you do not have a stress fracture, which is a small crack in the tibia.  An MRI will often show stress fractures in the tibia.  Tendinitis occurs when tendons become inflamed and this can be painful like shin splints.  An MRI can help diagnose tendinitis.  Compartment syndrome is a painful condition that occurs when pressure within the muscle builds to dangerous levels and causes symptoms like shin splints.  The tests used to diagnose this condition is measuring the pressure within the leg compartments before and after exercise.

Treatment of shin splints

Shin splints are typically caused by overuse, and standard treatment includes several weeks of rest from the activity that caused the pain.  Non-steroidal anti-inflammatory medicines reduce pain and swelling as well as using an ice pack.  Stretching your lower leg muscles may make your shins feel better.  Compression may prevent additional swelling and wearing supportive shoes with good cushioning during daily activities will help reduce stress in your shins.  Patients with flatfeet or recurrent problems with shin splints may benefit from orthotics which will help align and stabilize your foot and ankle, while taking the stress off of your lower leg. 

Before returning to exercise you should be pain free for 2 weeks.  It is advised to begin exercising at a lower level of intensity and not as often as you did before or for the same length of time.  Before exercise, your should warm up and stretch thoroughly.  Increase training slowly.