Also known as medial tibial stress syndrome, shin splints can be painful and cause disruption to training regimes. However, they are not a serious condition and can be treated with simple home remedies.
Shin splints account for an estimated 10.7 percent of injuries in male runners and 16.8 percent of injuries in female runners.
Aerobic dancers are among the worst affected and have shin splint rates of up to 22 percent.
Although high impact sportspeople are at a higher risk, even walkers can develop shin splints, especially if they increase their speed or distance quickly.
Despite the prevalence of shin splints, the precise mechanisms behind the condition are not known, although many of the main risk factors are now well-documented. In this article, we will look at the causes, diagnosis, and treatment of shin splints.
Contents of this article:
Here are some key points about shin splints. More detail and supporting information is in the main article.
- Shin splints are pains that run along the lower front of the legs, especially during or after sport
- Diagnosis of shin splints may involve an X-ray to rule out other causes
- The best treatment for shin splints is to cease the activity that caused the condition
- Using the appropriate footwear for sports is essential for preventing shin splints
- Less fit individuals and smokers are more at risk from this condition
What are shin splints?
Shin splints are one of the most common sporting injuries.
Shin splints are pains along the shinbones that run down the front of the lower leg (the tibia).
They are a common occurrence in people who indulge in activities that involve high impact stresses on the feet and legs.
Affected individuals include military personnel, dancers, and runners. Shin splints often occur when training routines are changed and the bones, tendons, and muscle tissues are overworked.
Some athletes are tempted to run through the pain, but, in the case of shin splints, this will exacerbate the issue and potentially damage underlying tissues. If possible, a 2-week rest from the particular activity that caused the injury is recommended.
Symptoms of shin splints
The symptoms of shin splints are:
- Pain and tenderness along the tibia
- Potential swelling of the lower legs
Initially, the pain will cease when exercise stops, but if the condition worsens, the pain can become constant.
Causes of shin splints
The exact physiological and anatomical origins of shin splints are not fully understood but are considered to involve a variety of different issues.
The causes, however, are relatively clear; shin splints are most commonly associated with repetitive activities that cause stress on the shin bone and the connective tissue that attaches the muscle to the bone.
It is theorized that these stresses involve inflammation of the connective tissue that coats the tibia (called the periosteum). This is called periostitis.
Many experts believe that a spectrum of tibial injuries might account for shin splints; some of these could include:
- Tendinopathy: a disease of the tendon.
- Periosteal remodeling: bone growth and regeneration.
- Muscle dysfunction: some muscles may be implicated in shin splints, including the tibialis posterior (inside of the ankle), tibialis anterior (running along the foot and big toe) and the soleus (lower calf).
Overpronation as a cause of shin splints
As far as anatomy is concerned, ankle overpronation is the greatest cause of shin splints. Overpronation of the ankle occurs when the ankle steadily moves downward and toward the center of the body.
The change in position places more of the arch in constant contact with the ground. More weight is placed on the inside of the foot (medial) than the outside edge of the foot (lateral).
This abnormal movement causes muscles to fatigue quicker and limits their shock-absorbing abilities. In a study investigating shin splints in the British infantry, the authors found:
"An imbalance in foot pressure with greater pressure on the medial side than on the lateral side was the primary risk factor."
Risk factors for shin splints
As mentioned, anyone who takes part in activities that involve high impact on the legs can suffer from shin splints. Other factors that increase the risk of shin splints include:
Shin splints can normally be treated at home.
- Smoking and general lack of fitness
- Sudden increase in exercise intensity
- Sports played on hard surfaces involving stopping or starting suddenly (like basketball)
- Activities taking place on uneven ground or slopes
- Pre-existing muscle imbalance, including weak core muscles
- Wearing worn-out shoes without adequate cushioning
- Weak ankles
- Tight Achilles tendon or calf muscles
- Flat feet, pronation, or high arches
Diagnosis of shin splints
Physicians can usually make a diagnosis by discussing the patient's medical history and carrying out a physical examination. X-rays may be taken to rule out other issues that might have similar symptoms.
Medical conditions that have similar symptoms to shin splints include:
- Reduced blood flow in the lower leg (more common in smokers)
- Leg muscle bulging out of place (muscle hernia)
- Swelling of muscles causing nerve compression (compartment syndrome)
- Nerve problems in the lower back (radiculopathy)
- Stress fractures - small cracks in the tibia
- Tendinitis - inflamed tendons
- Effort-induced venous thrombosis - blood clot caused by exertion
- Popliteal artery entrapment syndrome - muscles and tendons compress a specific artery
Treatment of shin splints
In the most part, shin splints can be treated with simple home remedies.
Remedies for treating shin splints include:
- Rest and recuperation: switch to lower impact activities such as swimming while the condition heals
- Keep the legs raised
- Place ice packs wrapped in towels on the affected area for 15 minutes every few hours until symptoms subside
- Over-the-counter medication such as ibuprofen, acetaminophen and naproxen sodium can help ease the pain
Once the pain has subsided, exercise can be resumed, but it must be built up gradually to prevent a recurrence. If the pain resumes, it is best to stop the activity immediately.
Prevention of shin splints
- Lessen impact: consider cross-training with lower impact sports like walking or biking. Choose soft surfaces over hard if possible. Begin any new activities slowly and gradually build up intensity.
- Wear correct footwear: wearing the right shoes for the job is important. For runners, shoes should be replaced every 300-500 miles.
- Use arch supports (orthotics): these can be helpful, especially for individuals with flat arches.
- Strengthen the area: try toe raises to strengthen the muscles of the lower leg - slowly rise onto tip toes and back again, repeating ten times.