How to Prevent and Treat Shin Splints

Shin splints are pains in your lower leg brought on by exercise, caused by overuse of the muscles. The condition is also called medial tibial stress syndrome.

Shin splints are common when people start a walking or running program, take up dancing, or start drilling 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 going faster, increasing your mileage, or switching to a new type of shoe.

The good news is that this pain can be treated with self-care. If you don't overdo your routine at first, you can soon put shin splints behind you. Learn more about how to avoid or treat shin splints.

Symptoms of Shin Splints

With shin splints, you feel a sharp pain or dull ache on the inside of your lower leg bone (the tibia) when you are walking, running, or dancing. It may be more towards the front of your leg with anterior shin splints or the back of your leg with posterior shin splints. There may also be some slight swelling at the inside of the lower leg, between the knee and the ankle.

When you first feel shin splint pain, it is likely to stop when you stop moving. That is typical for shin splints. If it continues to hurt after a few minutes of inactivity, it might be a sign that you are progressing to having a stress reaction or a stress fracture.

Causes of Shin Splints

Shin splints are an inflammation of the muscles, tendons, and bone tissue, believed to be caused by repetitive stress and overuse.

This is usually seen when suddenly increasing your physical activity, either with a new activity or by changing something in your current program. Did you add hills, uneven ground, or concrete surfaces to your running or walking route? Have you been adding more days and miles to your training?

Your foot arch can also be an added risk factor, with shin splints seen more in people with either flat feet or high, rigid arches.

Worn out shoes or changing shoe styles can increase the risk of shin splints. If you wear dress shoes or comfort shoes with a relatively high wedge heel, you may feel shin splints.

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

Preventing Shin Splints

If you want to avoid shin pain or you are easing back into your routine after recovering from shin splints, use these tactics.

1. Do not overstride. Overstriding when walking can contribute to getting shin splints. Keep your stride longer in back and shorter in front. Go faster by pushing off more with the back leg.
2. 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.
3. Shock-absorbing insoles for boots: Military boots and hiking boots lack cushioning. Adding a shock-absorbing insole has been shown to be helpful in studies of military personnel.
4. 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.

1. Replace old shoes: The cushioning and support in your athletic shoes is exhausted every 500 miles, often long before the soles or uppers show wear.
2. Warm-up before going fast: Warm up at an easy pace for 10 minutes before you begin a faster-paced or more intense workout.
3. Alternate active days: Don't engage in vigorous activity two days in a row. Give your shins and your other muscles a recovery day in between hard workouts or long activity days.

Treating Shin Splints

You can usually use self-care to get relief from shin splints. But you need to see your health care provider if your shins are red and hot to the touch, if you have swelling that is getting worse, or if the pain doesn't get better with self-care for several weeks.

These can be signs of compartment syndrome or a stress fracture.

Shin splints generally heal with rest and then steadily building strength in the calf muscles. Take these steps.

1. 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) until you are back. Dirt trails will be softest, but asphalt is also much better than concrete. If you have recurrent shin splints, you should take two weeks off from your exercise routine to allow your shins to heal. Use that time for other activities such as swimming or biking, which won't stress your shins.
2. Ice and Pain Relievers for Swelling: Use cold packs on your shins for 20 minutes at a time, several times each day, being careful that have a towel or fabric between your leg and the ice so it isn't in direct contact with your skin. You may also want to use an over-the-counter non-steroidal pain medication if you have swelling or continuing pain. If you are on any medications, you may want to discuss what is appropriate with your doctor.
3. Stretching and Strengthening for the Shins: Toe raises and shin stretches can help build the shin 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.
4. Arch Supports and 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 top-quality 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 stess syndrome.

After Recovery: Getting Back to Activity

Once you have been pain-free for two weeks, you might start back to the physical activity that triggered it. Use these tactics.

1. Seek softer surfaces: Avoid concrete and other hard surfaces for running, walking, or sports where possible. 
2. Stretch after warming up: Stop and do your stretching routine, especially the legs, after your warm-up.
3. Speed up only after warming up: If you feel the calf pain, slow down.
4. 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.
5. Ice after exercise: Ice your shins for 20 minutes after exercise.
6. Easy does it. Increase your exercise load by only 10 percent per week (mileage, duration, or intensity). Avoid competition until you have continued to be pain-free.

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.

Sources:

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Reshef N, Guelich DR. Medial tibial stress syndrome. Clin Sports Med. 2012 Apr;31(2):273-90. doi: 10.1016/j.csm.2011.09.008.

Shin Splints. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00407.

Shin splints - self care. MedlinePlus NIH. https://medlineplus.gov/ency/patientinstructions/000654.htm.