The term “shin splints” describes pain felt along the front of your lower leg/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 prevents your body from being able to naturally repair and restore itself.
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.
Various activities and physical attributes can put you at risk of getting shin splints. Risk factors include:
- an anatomical abnormality (such as flat foot syndrome)
- muscle weakness in the thighs or buttocks
- lack of flexibility
- improper training techniques
- running downhill
- running on a slanted surface or uneven terrain
- running on hard surfaces like concrete
- using inappropriate or worn-out shoes for running or working out
- participating in sports that have fast stops and starts (like soccer or downhill skiing)
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.
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
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.
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 anti-inflammatory, such as ibuprofen, naproxen sodium, acetaminophen
- wear elastic compression bandages
- use a foam roller to massage your shins
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 shins 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.
Steps you can take to avoid getting shin splints include:
- wearing shoes that fit well and offer good support
- using shock-absorbing insoles
- avoiding exercising 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
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.