How to Prevent and Treat Shin Splints

Shin splints are common when people start a walking or running program, take up dancing, or start drills as a military recruit. Even if you are an experienced runner and walker, you may feel shin splint pain when you change something about your routine, such as increasing your speed or mileage or switching to a new type of shoe.

What Are Shin Splints

Shin splints are pains due to inflammation in your lower leg, along the inner area of your shin bone, brought on by exercise and caused by overuse of the muscles. The condition is also called medial tibial stress syndrome and is very common, especially in runners, dancers, gymnasts, and those entering the military.

There are two types of shin splints, anterior and posterior, that occur in separate areas and cause different issues with the leg. If left untreated, shin splints of either type can lead to a stress fracture or the muscle detaching from the bone.

Symptoms

If you have shin splints, you may feel a sharp pain or dull ache on the inside of your lower leg bone (the tibia) when you are performing physical activities like walking, running, or dancing. The pain may be felt more towards the front of your leg with anterior shin splints or the back of your leg in the case of posterior shin splints. There may also be slight swelling around the inside of the lower leg, between your knee and ankle.

Shin splints can be:

• Either intense or dull and aching
• Felt during exercise or activity
• Painful or tender to the touch
• Continuous, leading to a stress fracture

Causes

Shin splints are an inflammation of the muscles, tendons, and connective tissue caused by repetitive stress and overuse. Overuse can occur when you start a new activity without pacing yourself properly and gradually building up a tolerance to the new exercise.

Overuse can also happen if you don't have enough rest and recovery time between training sessions. Other factors include anatomical issues with your feet or stride and wearing the wrong footwear.

Training Changes

Shin splints may occur when you suddenly increase your physical activity, either with a new activity or by changing something in your current program.

If you've added hills, uneven ground, or concrete surfaces to your running or walking route, you could be introducing too much stress too quickly to your body. The same goes if you've recently added more frequency, intensity, speed, or mileage to your training.

Foot Shape

The shape of your foot can play a role in your risk of getting shin splints. For example, your foot's arch can be an added risk factor, with shin splints seen more in people with either flat feet or high, rigid arches.

Improper Footwear

Worn-out shoes or not having the correct shoes for your feet can increase the risk of shin splints.

Stride

Overstriding can also cause shin splints. Overstriding occurs in running and walking when you extend your leading foot too far forward. It not only stresses your shins, but it's also inefficient and won't help your speed.

Treatment

You can usually relieve shin splints with self-care techniques. Take these steps to treat the condition if it occurs:

Rest

At the first sign of shin splint pain, stop your activity until the pain goes away. If you have to get back to your starting location, walk at an easy pace and try to walk on softer surfaces (rather than concrete). Dirt trails will be the softest, but asphalt is also much better than concrete.

If you have recurrent shin splints, you should take two to four weeks off from your walking or running to allow your shins to heal. Use that time for other activities such as swimming or biking, which won't stress your shins.

Compression Garments

Calf and shin compression may help prevent swelling from getting worse while you rest and recover. You can use an elastic bandage or a shin and calf compression wrap, leg sleeves, or knee-high compression socks to support the lower leg.

Ice and Pain Relievers

Use cold packs on your shins for 20 minutes at a time, several times each day, being careful to place a towel or fabric between your leg and the ice so the cold pack isn't in direct contact with your skin.

You can use an over-the-counter non-steroidal pain medication such as Advil (ibuprofen) if you have swelling or continuing pain. If you are taking any medications, ask your doctor which pain reliever is the best choice for you.

Heat Therapy and Massage

After the pain and swelling have subsided, which may take two to three days, you can use a heat therapy wrap for a few minutes before and after you exercise, whether that's after you return to your normal walking and running activities or any other training.

A deep tissue massage of the shin muscles and tendons may also feel good. Look for a sports massage professional to help with this if you think it would be beneficial for you.

Rehab Exercises

Stretching and strengthening the calf muscles can help treat and prevent shin splints, as tight calf muscles are a cause of the condition. Toe raises and lower leg stretches can help build the surrounding muscles and improve their flexibility so you can overcome shin splints.

You may want to consult a physical therapist to learn the exercises and techniques you need to strengthen and balance your leg muscles.

Proper Footwear

While you are recovering, check your footwear to see if it is time to replace your shoes. It's a good time to visit a specialty athletic shoe store and get fitted for the right footwear for your activities.

You may also want to consult a podiatrist about whether arch supports or orthotics are appropriate for your arches. Studies have found orthotics to be useful in preventing medial tibial stress syndrome.

Recovery

Once you have been pain-free for two weeks, you may start back to the physical activity that triggered your shin splints. Use these tactics to avoid a relapse:

• Easy does it. Don't rush back into the same level of intensity as you were doing before. Go slowly and take rest days.
• Stretch after warming up. Stop and do your stretching routine, especially the legs, after your warm-up.
• Speed up only after warming up. If you feel shin pain, slow down.
• Seek softer surfaces. Avoid concrete and other hard surfaces for running, walking, or sports where possible. 
• Slow or stop if you feel shin splint pain. If the pain does not go away quickly at a lower speed, end your running or walking workout.
• Ice after exercise. Ice your shins for 20 minutes after exercise.

Prevention

If you want to avoid shin pain or you are easing back into your routine after recovering from shin splints, consider these do's and don'ts to keep your legs healthy and injury-free.

Do

• Alternate active days. Don't engage in vigorous activity two days in a row. Give your shins and your other muscles a recovery day between hard workouts or long activity days.
• Add in cross-training. Increasing your strength and building muscle can help relieve pressure on your lower limbs. The core muscles are often weaker and not able to provide enough support when you start training. Increasing your strength and stability can help prevent strain on your shins.
• Choose walking shoes with flexible soles and low heels. If you wear inflexible shoes with rigid soles, your feet and shins fight them with each step. Walkers can avoid shin splints by choosing flexible shoes, even if they are labeled as running shoes. Walking shoes should be relatively flat, without a built-up heel.
• Get fitted for running and walking shoes. Overpronation is a risk factor for shin splints, according to studies. A technical running shoe store will assess you for overpronation and recommend a motion control shoe if needed.
• Replace your footwear every 350 to 500 miles.
• Get shock-absorbing insoles for boots. Military boots and hiking boots lack cushioning. Adding a shock-absorbing insole has been shown to be helpful.

Don't

• Keep shoes too long. Replace old shoes regularly. The cushioning and support in your athletic shoes are exhausted every 500 miles, often long before the soles or uppers show wear.
• Overstride. Overstriding when walking or running can contribute to getting shin splints. Keep your stride longer in the back and shorter in front. Go faster by pushing off more with the back leg.
• Skip the warm-up. Warm-up with a slow jog before running fast. When walking, warm-up at an easy pace for 10 minutes before you begin a faster-paced or more intense workout.

A Word From Verywell

Don't let shin splints stop you from enjoying physical activity. They can be a slight bump in the road that you can overcome. While you heal, try activities that don't stress your shins, such as swimming, cycling, and strength exercises. It's smart to enjoy a variety of types of exercise and activities.