Causes, Treatment, and Prevention of Shin Splints

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Shin splints describes a variety of generalized shin pain that occurs in the front of the lower leg along the shin bone (tibia). The pain of shin splints is typically located on the outer front portion of the lower leg (anterior shin splints) or pain on the back inside of the lower leg (posterior medial) shin splints.

Shin splints generally occur after cumulative stress causes microtrauma to the soleus muscle at the point of attachment to the shinbone. Repetitive stress can also cause irritation of the posterior tibialis muscle and inflammation of the periosteum, the connective tissue that covers the tibia. Shin splints almost always are the result of overloading these soft tissues through repeated impact activities, without proper conditioning or allowing enough recovery time between workouts.

What Causes Shin Splints?

Most athletes who develop shins splints will describe an exercise history that includes sudden increases in intensity or duration of impact activities, often along with a lack of appropriate recovery between workouts.

There are a variety of factors that can lead to shin splints. The most common cause is repeated trauma to either the muscles or bones of the lower leg.

Muscle trauma (exertional compartment syndrome) is often related to overtraining or excessive running on hard surfaces. Repeated use makes the muscles swell and puts pressure on the fascia that covers the muscles in the lower leg leading to pressure and pain.

Bone trauma to the lower leg can result in stress fractures. Constant pounding the leg bones may cause microscopic cracks and fractures in the tibia and fibula (lower leg bones). Rest is needed to repair these cracks, but without adequate recovery, these cracks continue to grow and become a fracture. The result is acute pain and a long recovery.

Beginning runners are at increased risk of shin splints and stress fractures because they are not used to the high impact running has on the muscles and joints of the lower leg and foot. Running on hard surfaces (especially with worn, poorly cushioned footwear) increases stress on the muscles, joints, and bones and is another cause of shin splints. Excessive pronation or other biomechanical problems can increase the risk of developing shin splints.

The Most Common Causes of Shin Splints

  • Improper stretching
  • Lack of warm-up
  • Training too hard
  • Increasing mileage too quickly
  • Running or jumping on hard surfaces
  • Muscle imbalance between the posterior and anterior leg
  • Worn out shoes that do not have enough support
  • Running on a tilted or slanted surface
  • Other biomechanical issues

Symptoms of Shin Splints

  • Pain located on the medial (inside) part of the lower leg
  • Pain is often worse with running or another weight-bearing exercise
  • Pain increases after running on hard surfaces
  • An aching pain may linger after stopping activity
  • Pain increases with activity
  • Pain increases with running, jumping, hill climbing, or downhill running
  • Calf muscles may be tight and inflexible

Shin Splints Treatment

Rest is the best treatment for shin splints. For immediate relief use the R.I.C.E. treatment method for controlling pain and inflammation. Returning to activity must be done gradually with non-weight bearing activity (cycling, swimming) to your workouts until pain-free.

  • Strengthening and stretching exercises are helpful. The ankle injury rehab program can also be used for shin splint rehab.
  • Tape your shins to reduce stress
  • Wear proper footwear
  • Replace shoes as needed.

Returning to activity must be done gradually or you risk re-injury. Change your routine and cut your exercise time and intensity so that you have no discomfort before, during or after exercise.

If your shin pain continues after three or more weeks, you should consider seeing your physician for a proper diagnosis.

View Article Sources
  • Duke University School of Medicine. May, 2006