Shin Splints – Symptoms – Causes – Treatment
About shin splints
Your shin bone (tibia) is at the front of your lower leg. It’s the largest of the bones that run from your knee to your ankle.
Shin splints is a general term used to describe any condition that causes pain and tenderness down the middle, or just inside the inner edge, of your shin.
Shin splints usually develop when you’re exercising and often get worse the longer you exercise. The condition usually develops in people who do repetitive activities and sports that put a lot of stress on the lower legs, such as running, jumping or dancing.
Symptoms of shin splints
The main symptoms of shin splints are tenderness and an aching pain along the front of your lower leg. The pain usually happens when you’re exercising and may become worse the longer you’re exercising. Some people find that the pain stops when they stop exercising, only to come back a few hours later. If your shin splints are severe you may have pain when you’re resting.
Causes of shin splints
There are a number of different causes of shin splints. The main ones are listed below.
- Stress fractures. These are small breaks in your tibia, caused by stress on the bone. They can develop after repeated exercise; for example, running or dancing over a long period of time.
- Medial tibial stress syndrome. The cause of medial tibial stress syndrome isn’t fully understood. When you’re exercising repeatedly you may feel pain at the middle to lower third of the inside of your tibia. It may also be swollen and tender.
- Compartment syndrome. This happens when your muscles swell. Your muscles sit inside an enclosed compartment, so they don’t have much room to expand. When your muscles swell, the pressure increases and blood can’t flow into the muscle properly. This causes severe pain.
All of these conditions can develop when you put too much stress and strain on your shin bone. This happens when there is repeated impact on the bone when you’re playing sports or doing activities where you’re running and jumping.
You’re more at risk of developing shin splints if:
- you’re running or playing sport often, for long sessions and at a high intensity
- your sport or activity involves running or jumping on a hard surface
- you have poor running technique
- you increase the amount of exercise you’re doing too quickly
- your shoes don’t fit well or don’t have enough cushioning and support
- you change your running pattern and the surface that you run on; for example, going from running on a treadmill to running on the road
Diagnosis of shin splints
If you have shin pain, see your GP, a chartered physiotherapist (health professional who specialises in maintaining and improving movement and mobility), or a sport and exercise medicine doctor. He or she will ask about your symptoms and examine you. Your GP, physiotherapist or doctor may also ask you about your medical history. There is usually a clear link between pain in your shin and a sport or activity that you do.
Your GP, physiotherapist or doctor may recommend that you have a scan or X-ray to look at your shin in detail. These tests are often done to rule out other conditions that may affect your shins, such as large stress fractures. The tests you may have are listed below.
- MRI scan. This uses magnets and radiowaves to produce images of your shin bone and surrounding soft tissues.
- An X-ray. This is a test that uses radiation to produce an image of the inside of your body.
- CT scan. This uses X-rays to make a three-dimensional image of your shin bone.
- A bone scan. This looks for abnormalities or changes in your bones.
Treatment of shin splints
There are many things that you can do at home to treat shin splints. The main ones are listed below.
- Stop doing the activity that caused your shin splints and rest for a few weeks. If you have stress fractures these can take up to 12 weeks to heal properly.
- If you need pain relief, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
- Check your trainers or sports shoes to make sure they are giving your feet enough support and cushioning. Specialist running shops can give you advice and information about your trainers. Orthotic insoles for your shoes may also help to improve the way you run.
- If you’re overweight, losing weight may help to treat shin splints.
- When you start exercising again, start slowly and at a low level. If you get shin splints again, stop the activity and rest for a few days before starting the exercise at a lower level of intensity. Build up the amount of exercise you’re doing gradually.
- Run on a soft surface such as grass, rather than the road.
Your physiotherapist can develop a training programme to gradually increase your activity and help you return to your usual sports activities. He or she may use a range of different treatments to help your recovery, including massage and stretching exercises.
If your shin splints are caused by compartment syndrome and your pain is severe, your doctor may suggest an operation called a fasciotomy. This releases the pressure on the muscles in your lower leg. Talk to your GP or physiotherapist for more information. Occasionally a stress fracture may need an operation help it heal.
Prevention of shin splints
You can help reduce your risk of developing shin splints by doing the following.
- Wear sports shoes or trainers that cushion and support your feet.
- Wear cushioned insoles to absorb some of the impact when you’re running or playing sport.
- Wear orthotic shoe inserts if your GP or physiotherapist advises you to.
- Train and exercise on grass if possible and don’t run on hard surfaces such as road or running tracks.
Produced by Rebecca Canvin, Bupa Health Information Team, June 2012.
Typical Areas of Shin Splints