Shin splints is the name for pain or soreness of the lower leg, along the inside edge of the shin bone (tibia).

Shin splints are medically known as medial tibial stress syndrome (MTSS). The condition has been recognized and treated for many years, but the specific mechanism that causes the pain isn’t clearly understood.

It’s a common injury for runners, dancers, athletes, and those in the military, but anyone who walks, runs, or jumps can develop shin splints from repeated leg stress or overuse. Here is what you can do for it.

Here is a basic at-home treatment routine that you can use for self-care:

Rest, but not too much

It’s important to give yourself a break from high-impact activities, until your pain goes away. You may need to rest for two to six weeks.

Don’t stop all activity, just those that cause you shin pain or that pound your legs hard. For exercise, try low-impact activities such as:

  • swimming
  • stationary cycling
  • walking
  • water walking
  • exercise on elliptical machines

When your pain has improved or stopped, ease back into your former activity or exercise routine. If you run, for example, run on soft ground or grass and start out for shorter periods. Gradually increase your exercise time.

Ice

Use an ice or cold pack on your legs for 15 to 20 minutes at a time, 3 to 8 times a day. This will help reduce pain and swelling. Continue the ice treatment for a few days.

Wrapping the ice in a thin towel can make it more comfortable for your legs. You can also use the cold pack to massage the area of pain.

Elevate

When you’re sitting or laying down, keep your legs elevated on pillows to reduce swelling. The point is to elevate your legs to a level that is higher than your heart.

Anti-inflammatories and pain relievers

Take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) such as:

  • ibuprofen (Advil, Motrin IB)
  • naproxen (Aleve)
  • acetaminophen (Tylenol)

Compression

Your doctor may recommend that you wear compression stockings or compression bandages when exercising. Compression sleeves can be purchased at sporting goods stores, drugstores, or online.

A 2013 study on the effectiveness of compression stockings for runners was inconclusive. The stockings reduced lower leg swelling after running, but didn’t make a difference in leg pain.

Massage

You can try self-message for pain, using a foam roller along your shins.

Gradual return to activities

A gradual return to your former sport or activity is best. Discuss a phased plan with your doctor, physical therapist, or trainer. One study suggests a 50 percent reduction in the intensity, length, and frequency of your activity to begin with.

Rest and ice packs are considered to be the most important things you can do in the acute phase, or, start, of your shin splints.

If your pain is persistent or if you’re intending to “work through it,” you may want to discuss other treatment options with your doctor.

There aren’t many controlled research studies on whether some treatments are more effective than others.

A professional therapist can provide you with exercises to stretch and strengthen your calf and ankle muscles.

Once you’re not in pain, a therapist may also give you exercises to strengthen your core muscles. If necessary, a therapist can provide specific exercises to correct any muscle or mechanical abnormalities that may contribute to your getting shin splints.

Other physical therapy treatments for shin splints include:

  • pulsed ultrasound to increase circulation and decrease inflammation
  • ultrasound with a medicated gel for pain
  • soft tissue massage for pain
  • cold therapy (cryotherapy) to increase circulation and decrease inflammation

The application of low-energy shock waves to the shins can be an effective treatment for chronic shin splints and can shorten the healing time.

Technically, this is known as extracorporeal shock wave therapy, or ESWT. A 2010 study of 42 athletes found that ESWT combined with a graduated exercise program had better results than the exercise program alone.

One of the things to check is the fit and support of your athletic or walking shoes.

Wear well-fitting shoes appropriate for your particular activity. Appropriate footwear can reduce the risk of shin splints. For some people, the addition of shock-absorbing insoles may be useful.

A doctor can refer you to a foot specialist (podiatrist) to be fitted for orthotics to correct any imbalance in your feet. Over-the-counter orthotics may work for some people.

Fascia (plural fasciae) refers to the connective tissue under the skin that attaches to muscles and other organs.

A small study reported in 2014 found that fascia manipulation reduced pain in runners with shin splints and enabled them to recover faster and run longer without pain.

It’s based on a theory that the pain in shin splints (and in other types of injuries) comes from distorted fascia or disturbances in the fascial layer. The name for this theory is the fascial distortion model (FDM).

This method of manually applying strong pressure with the thumb to points on the lower leg in pain is controversial. According to a 2018 review of research there haven’t been any clinical trials or studies of this method.

Many sports medicine practices use FDM in treatment. There’s a national association for FDM. However, its practice has been disputed.

A small study reported in 2000 found that acupuncture helped relieve pain in running athletes with shin splints. Specifically, acupuncture enabled runners to reduce the NSAIDs they were taking for pain.

The author of the study notes that more research is needed.

Cortisone injections for pain are not recommended.

Types of injections to promote healing include injections of autologous blood or platelet-rich plasma, but there’s not enough research to show effectiveness.

No braces or splints

Leg braces or splints have been found to be not effective with shin splints. But they may help with tibia fractures.

Most people with shin splints recover with nonsurgical treatments at home. But it’s a good idea to see your doctor if your pain persists or is acute. They may want to check to see if there’s a stress fracture, tendinitis, or another problem causing your leg pain.

Your doctor may also recommend specific exercises, preventative measures, and orthotics for your shoes. Or, they may refer you to an orthopedist, sports medicine specialist, or physical therapist.

In very rare cases when shin splints don’t respond to conservative treatment, a doctor may suggest surgery to relieve pain. There’s limited research on the results of shin splint surgery.

In a procedure called a fasciotomy, the surgeon makes small cuts in the fascia tissue around your calf muscles. In some cases, surgery includes burning off (cauterizing) a ridge of the tibia.

Results from studies have varied. A small, dated study of 35 top athletes who underwent surgery found that 23 improved, 7 were unchanged, and 2 had poor results. Another small study found that 79 percent of people who had shin splint surgery had a good or excellent outcome.

If your shin splint pain persists, it’s important to see a doctor for treatment. Sometimes simple changes in your exercise routine or your footwear can prevent the problem from recurring.

It’s also possible that your leg pain has another cause. Your doctor may want you to have an X-ray or other type of scan to see if you have a tibia fracture or another problem in your leg.

Treating shin splint pain and taking preventive measures to keep the pain from returning will keep you able to exercise pain-free.

Don’t try to be a martyr and keep up an intense exercise routine while you’re in pain. This will only increase the likelihood of further damage to your legs.

When you have shin splints, treat them and discuss a graduated program of return to exercise with your doctor, physical therapist, or trainer.

Shin splints, or MTSS, is a very common leg injury. Early treatment with rest and icing can successfully help manage pain. Try alternative kinds of low-impact exercise when your pain subsides.

Other treatment options are possible if pain persists or the injury keeps recurring. More research is needed to compare the effectiveness of these options.

Surgery is rare and is a last resort when all else fails.

It’s most important to reintroduce your exercise program or activity gradually, when your pain has subsided. Discuss preventive measures with your doctor or physical therapist.