Shin splints are characterized by pain in the lower leg, on the front, outside, or inside of the leg. Often, the pain starts as the exercise begins, gradually gets better as the session continues, then gets worse again after exercising is complete.
People who take part in high impact sports have the highest risk, but even walkers can develop shin splints, especially if they increase their speed or distance quickly.
Despite the fact that shin splints are very common, the exact reason why they occur is still not known; however, 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. We will also explain how to prevent them from occurring.
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 stop 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.
What are shin splints?
Shin splints are relatively common in sportspeople.
Shin splints are pains that occur along the front of your lower leg or tibia bone.
They are a common occurrence in people who indulge in activities that involve high impact stresses on the feet and legs.
Shin splints affect a range of people, including military personnel, dancers, and runners; they often occur when training routines are changed, and the bones, tendons, and muscle tissues are overworked.
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.
Some athletes are tempted to run through the pain, but, in the case of shin splints, this will make the issue worse and potentially damage underlying tissues. If possible, a 2-week rest from the activity that caused the injury is recommended.
The symptoms of shin splints are:
- Pain and tenderness along the tibia.
- Potential swelling of the lower legs.
- In chronic cases, there may be lumps or bumps felt along the bones.
- In severe cases, there may be red patches on the skin around painful areas.
Initially, the pain will stop when exercise stops, but if the condition worsens, the pain can become constant.
It is important to have the pain checked by a doctor because other conditions have similar symptoms (see section on diagnosis).
The exact mechanisms behind shin splints are not fully understood but are thought 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 shinbone and the connective tissue that attaches the muscle to the bone.
It is thought 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 range 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 also be involved in shin splints, including:
- tibialis posterior (inside of the ankle)
- tibialis anterior (running along the shin and top of the foot)
- soleus (lower calf)
Overpronation as a cause of shin splints
Foot and ankle overpronation is also thought to be a cause of shin splints. Overpronation of the foot/ankle is when the foot steadily moves downward and toward the center of the body.
This change in position places more of the arch of the foot 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).
"An imbalance in foot pressure with greater pressure on the medial side than on the lateral side was the primary risk factor."
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:
A sudden increase in exercise intensity increases the risk of shin splints.
- 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, overpronation, or high arches.
In the most part, shin splints can be treated with simple home remedies. Remedies include:
- Rest and recuperation: switch to lower impact activities such as swimming while the condition heals.
- Place ice packs wrapped in towels on the affected area for 15 minutes every few hours until symptoms subside.
- Over-the-counter medications such as ibuprofen, acetaminophen, and naproxen sodium can help ease the pain.
- Gently stretch the Achilles' tendon.
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 and see a doctor or physical therapist to develop a more fine-tuned treatment approach.
The following tips might help reduce the chances of shin splints developing:
- 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 the 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 tiptoes and back again, repeating ten times.
Doctors can usually make a diagnosis by discussing the patient's medical history and carrying out a physical examination. X-rays might be taken to rule out other issues that 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 - a blood clot caused by exertion.
- Popliteal artery entrapment syndrome - muscles and tendons compress a specific artery.