Shin Splints

Shin splints are repetitive strain injuries. They can cause pain and tenderness on the inside front of the lower leg. Runners or those involved in running sports are at a higher risk of developing shin splints. However, others from all walks of life can get them as well.

You can properly recover from shin splint pain and resume normal activities in 2 to 4 weeks. However, they may require 3 to 6 months to heal completely.

Overview

What are shin splints?

Shin splints refer to pain and tenderness on the inside front of the lower legs (the shins). This is the result of small tears and inflammation in the muscles, tendons, and bone tissue around the shin bone.

More specifically, the pain occurs when muscles and tendons pull too hard on the periosteum, the lining of this bone. This lining is attached to nerve tissue, which is very sensitive.

Athletes often have shin pain after repeated lower leg stress with running, running sports, or hard exercise. Shin splints are common overuse injuries usually caused by training errors and running too much, too quickly.

Most people recover with rest or a significant decrease in training, combined with icing the shin. However, if left untreated, shin splints can cause other issues.

Runner sits on the pavement, massaging shin splints in their right leg.

Medical Term Breakdown

The medical term for shin splints is medial tibial stress syndrome (MTSS):

  • “Medial” means toward the middle or center.
  • “Tibial” refers to, of, relating to, or located near a tibia.
  • “Tibia” is the larger of the two bones between the knee and ankle, also called the shin bone.
  • “Stress,” in this instance, refers to the body’s response to physical pressure.
  • “Syndrome” refers to a mix of symptoms and physical characteristics for a specific condition where the direct cause isn’t clearly understood.
Symptoms and Causes

What are the symptoms of shin splints?

The most common shin splint symptoms are:

  • Lower leg pain while running, especially at faster speeds.
  • Pain felt on the inside edge of the leg or in front of the tibia (the shin bone).
  • Shin pain ranging from a sharp to a dull ache that gets worse after the activity has ended.
  • A shin that is tender to touch, with mild swelling.
  • Tight calf muscles.
  • Decreased ankle flexibility.

What causes shin splints?

Shin splints develop when the shin’s muscles, tendons, and bone tissue become overworked by repetitive activity. This irritates the calf muscle attached to the shin bone.

Shin splints are common for new runners or those returning to running after an extended break. They also occur for running and jumping athletes who have rapidly increased the duration and intensity of their workouts too quickly.

Additional risk factors for shin splints include:

  • Wearing the wrong footwear for a specific athletic activity or using shoes that are in poor condition.
  • Running too much on hard surfaces.
  • Inadequate stretching before and after working out.
  • Lack of lower extremity flexibility or strength.
  • Running on a slanted surface, downhill, or uphill.
  • Having flat feet or abnormally rigid arches.
  • Excessive pronation, where most or all of the body’s weight rests on the inside sole of the foot.
  • Walking extreme distances.
  • Having a vitamin D deficiency or eating disorder.
  • Having weak bones from osteoporosis.

Once you have shin splints, you must give them time to recover. When the shin doesn’t have time to heal, the damage can worsen and significantly increase pain.

Diagnosis

When should I see a doctor for shin splints?

Most people with shin splint pain never need a doctor for a formal diagnosis. However, you should see a doctor if your shin pain is severe or doesn’t go away after a few weeks. Untreated shin splints can lead to stress fractures.

You should also see a doctor if you have symptoms that don’t fit the traditional shin splint profile:

  • Stress Fracture. If you feel pain localized in one spot rather than spread out, it could be a sign of a stress fracture. This type of injury occurs when the tibia (shin bone) develops a small crack due to excessive stress and overuse.
  • Compartment Syndrome. If you’re feeling pain on the outside of the front of your leg rather than on the inside, it may be chronic exertional compartment syndrome. This condition occurs when the pressure in your muscles increases to dangerous levels. This condition is normally brought on by exercise.
  • Tendinitis. When tendons become inflamed, it can result in tendinitis, which can be painful. The pain is similar to shin splints, especially if the shin tendon has a partial tear.

How are shin splints diagnosed?

A doctor will examine a patient’s lower leg, ankle, and foot to diagnose shin splints and review their medical history. They will ask about the symptoms and activity level leading to the injury.

A doctor may additionally request imaging exams to eliminate other possible causes of shin problems. Shin pain can also be caused by conditions such as tendinitis, stress fractures, and chronic exertional compartment syndrome.

Treatment

How are shin splints normally treated?

Typically, at-home care and nonsurgical methods are used to treat shin splints.

  • Rest. The standard course of treatment includes a period of rest. Several weeks should be taken off from the activity that caused the pain. This break allows the body to help resolve the pain and inflammation.
  • Substitute. Substitute lower-impact cardio exercises such as swimming, riding a stationary bike, or utilizing an elliptical trainer.
  • Ice. Apply ice packs for 20 minutes several times a day. Shin splint pain and swelling can be reduced by applying ice.
  • Pain relievers. Ease pain and swelling with over-the-counter (OTC) nonsteroidal anti-inflammatories (NSAIDs). NSAIDs include aspirin, Ibuprofen, and Naproxen Sodium. However, if you use them for more than ten days, your doctor should monitor you for side effects.
  • Supplements. According to research, one of the factors with shin splints is vitamin D deficiency. So, taking vitamin D3 supplements may help prevent the pain from recurring. Speaking with your physician before taking any supplements is important to ensure they are safe for your overall health.
  • Compression sleeves. Use shin sleeves or shin wraps. Strategically compressing your legs can help increase blood flow to your shins, promoting healing.
  • Flexibility exercises. Gently stretching your tight calf muscles can help accelerate recovery. Shin splint stretches can also help to relieve pain.
  • Slow increase in activity level. As your shins become pain-free, start slowly as you return to regular activities. Gradually increase the intensity and distance of your workouts to avoid reinjuring your shins.
  • Supportive athletic shoes. Wear proper athletic footwear and consider adding arch supports or insoles to absorb shock and impact.
  • Physical therapy. Physical therapists can use manual therapy to help reduce inflammation and pain.

How long does it take to recover from shin splints?

Shin splints can take anywhere from one to six months to heal. You should avoid vigorous exercise or sports for at least two to four weeks, resuming only when the pain of shin splints is gone. Take your time transitioning back into sports or exercise, as shin splints can easily return.

Prevention and Outlook

How can I reduce my risk for shin splints?

There are steps that you can take to lower your risk for shin splints:

  • Wear properly fitting athletic shoes. The variety of athletic shoes available today covers every nuance of body types and sports. Consider going to a specialty running shoe store. With their expertise, they can find the ideal shoe. They’ll base their recommendations on your foot type, physique, running pattern, and workout routine. Replace your shoes every 300 to 500 miles of use or when they feel worn down.
  • Slowly build your fitness level. Start slowly and increase your exercise regimen’s duration, intensity, and frequency over time.
  • Improve your running form. Adjustments in running form can lessen the impact on the body, decreasing the likelihood that the shin splints will become chronic or more painful.
  • Cross-train. Use cross-training and alternate it with lower-impact sports like swimming or cycling.
  • Avoid running on hard surfaces. Running on hard surfaces can lead to more stress and result in injuries like shin splints, Achilles tendonitis, and stress fractures.
  • Stretch and warm up before starting to exercise and stretch afterward. Start with light activity before intense exercise, which will loosen up your shins and increase blood flow. Never stretch to the point of pain.
  • Let pain guide you. If you notice shin pain, don’t push through it. Reduce your activity level until it improves.
  • Target a healthy body weight. Excess weight places greater demand on the body’s joints and muscles when exercising.

What is the outlook for shin splint recovery?

After taking time off from sports and activities, most individuals with shin splints experience recovery. Shin splints can take anywhere from one to six months to heal. You should be able to begin to build back into exercise or sports in two to four weeks if the pain is gone.

Video Overview: Shin Splints