Shin Splints

By: Ehren Allen, DPT, COMT

What You Need to Know About Shin Splints

Shin splints are a common issue that many people, especially those who are active or athletic, often experience. This article will offer you a comprehensive understanding of shin splints, discussing its causes, symptoms, and how to diagnose it. Regardless if you're a professional athlete or just someone who enjoys regular exercise, having knowledge about shin splints is crucial to prevent further complications.

What Are Shin Splints?

Shin Splints are a general way describe a pain in the lower leg. The pain is typically in the distal two-thirds of the lower leg. Shin Splints can be split into 2 categories:

  1. Anterior Shin Splints (front of the leg)
  2. Posterior Shin Splints (back of the leg)

Shin splint pain can come from several issues. These include:

Understanding Shin Splints

Shin splints are medically referred to as medial tibial stress syndrome (MTSS).  They are the cause of pain and inflammation along the shinbone (tibia). They usually occur during activities that place repetitive stress on the lower leg, like running, jumping, dancing, or playing sports such as basketball or soccer.

There are two main types of shin splints, anterior shin splints and posterior shin splints. Anterior shin splints occur on the front and outer side of the shin, affecting the muscles and tendons that control the foot and toes. Conversely, posterior shin splints appear on the inner side of the shin, affecting the muscles that control foot and ankle movement.

Misconceptions About Shin Splints

 One misconception is that shin splints are only caused by impact forces on the shinbone. While excessive impact can lead to shin splints, other factors like overpronation (inward rolling of the foot), muscle imbalances, improper footwear, and training errors can also contribute significantly.

Another misconception is that rest is the only solution for shin splints. While rest is crucial for recovery, it is often not enough to fully resolve the issue. Shin splint treatment may also include stretching and strengthening exercises, orthotics or shoe inserts, physical therapy, and adjusting training techniques to reduce stress on the shinbone.

Distal Tibia Shin Splint JOI REHABShin Splint X-Ray

What is Medial Tibial Stress Syndrome?

Medial Tibial Stress Syndrome or MTSS is an issue that effects the inside part of the lower leg bone called the Tibia. It is believed that multiple structures in the medial tibial region are involved with the pain of Shin Splints including:

  • Periosteum (outer layer of the bone)
  • Muscle
  • Tendon

What Muscles Are Involved with Shin Splints?

Muscles associated with shin splint pain are:

  • Anterior Shin Splint Pain - Anterior Tibialis

Shin Splints anatomy label JOI REHABAnterior Tibialis

  • Posterior Shin Splint Pain - Posterior Tibialis

Anatomy Posterior tibialis muscle Shin Splint JOI REHABPosterior Tibialis

Causes and Risk Factors of Shin Splints

Shin splints are a frequent issue among athletes and active individuals. Knowing the causes and risk factors of shin splints can aid in preventing and managing this painful condition.

Several activities can lead to shin splints. High-impact sports such as running, basketball, soccer, and tennis put a lot of stress on the lower legs, increasing the risk of shin splints. Furthermore, sudden increases in training intensity, duration, or frequency can also lead to shin splints. Changing surfaces for training is another cause for pain.  Running on the beach one day and running on concrete the next day. 


Biomechanical factors are critical in the development of shin splints. Individuals with flat feet or high arches are more prone to shin splints due to abnormal force distribution on the lower legs. Other factors such as poor running or walking technique, inadequate footwear, and muscle imbalances can also lead to shin splints.

Besides the activities and biomechanical factors, there are other risk factors that increase the likelihood of shin splints. These include a history of previous shin splints, inadequate warm-up or cool-down routines, insufficient rest and recovery, and playing sports on hard surfaces.

Here at JOI Online, we understand the importance of preventing and managing shin splints. Our range of treatment products, including supportive footwear, orthotic inserts, and compression sleeves, can provide necessary support and protection to help alleviate shin splint symptoms and prevent further injury. We aim to empower individuals to stay active and pain-free by addressing the causes and risk factors associated with shin splints.

Shin splints can occur for several reasons depending on the person.  The most common causes of shin splints are: 

Shin Splints are more common with:

  • Dancers
  • Frequent starting and stopping with sports.
  • Military Activity
  • Track or Cross Country
  • Early season basketball   

Recognizing the Symptoms and Diagnosis of Shin Splints

Shin splints are a common injury, especially among athletes, runners, and dancers. They cause pain and discomfort along the shinbone (tibia). Recognizing the symptoms and understanding how shin splints are diagnosed can help you address the issue quickly and effectively. Shin splints typically hurt more during and after impactful exercise activities such as running. Shin splints can cause pain in the shin bones. 

The main symptom of shin splints is pain and tenderness along the inner edge of the shinbone. This pain can vary from a dull ache to a sharp, stabbing sensation. It is usually experienced during or after exercise, particularly activities involving repetitive impact, such as running or jumping. Some individuals may also notice swelling or mild redness in the affected area.

To diagnose shin splints, your physician will typically conduct a thorough physical examination. They will review your medical history, discuss your symptoms, and may ask about your exercise routine. In some cases, imaging tests like X-rays or MRI scans may be ordered to rule out other potential causes of your symptoms.

Treatment for Shin Splints?

The best way to heal shin splints is to rest them!  Bone and muscle tissue will heal, but limiting the excessive forces can help it heal faster and better.  The ice cup is a good tip for you to help heal your shin splints. You can also help the pain and healing process with:

  • Stretching the calf
  • ice or ice cup.
  • massage
  • anti-inflammatories
  • laser therapy 

Ice massage for shin splintsIce cup for Shin Splints

What Do Shin Splints Feel Like?

Shin splints are small tears in the muscle and bone tissue in the front of the shin bone (tibia).  The pain can vary from mild to severe.  You will notice you have pain or soreness along the inside of your shin bone. Some report that it feels like razor blades in the inside/front of the lower leg.  Others report aching and soreness in the area with exercise.  Shin splints can also be very tender to the touch.  

Massaging of shin for shin splint JOI REHABPerson holding Shin due to Shin Splint

Can You Still Run with Shin Splints?

Shin splints typically hurt with running. The impact of running can irritate the micro-tears in the muscles and bone and cause pain to increase.  Pain may increase as running continues.  It is possible to run with shin splints, but it may make them worse.  

Running can lead to shin splints in some people. Running allows up to six times the bodyweight to translate through the shin with every step. Over time, this force can cause micro-trauma to the muscle and bone tissue in the shins.  

If the foot's arch is stiff and rigid, the force of running may translate to the shin, which can lead to microtrauma in the muscle and bone tissue in the tibia. Orthotics may help to reduce the excessive impact forces with running with stiff arches.  

Do Shin Splints Go Away?

Shin splints can improve or go away, but it is important to address the cause. This may include:

  • Stretching tight calf muscles
  • Orthotics or your shoes
  • Altering running patterns
  • Strength training for the hip, knee, and ankle
  • Alter G Treadmill
  • Ice

What is the Best Shin Splint Stretches?

The quick answer is the best stretches for shin splints is to stretch the calf muscles.  This can be done by standing on a step and dropping the heel off of the step.  

Place more weight on that leg to stretch the calf muscles more. Hold stretches for 30 seconds and repeat 3 times. 

step stretch exercise for shin splints.Step stretch for shin splints

Does Massage Help Shin Splints?

Medical Massage Therapy can help with the pain of shin splints. Massage can break down abnormal scar tissue and promote proper muscle fiber movement. Massage may be uncomfortable. It is important to drink lots of water and use ice afterward to limit soreness. 

It's important to note that shin splints can sometimes be confused with other conditions, such as stress fractures or compartment syndrome. There are, however, a few key factors that can help distinguish shin splints from these other issues. Unlike stress fractures, shin splints tend to cause pain along a broader area of the shinbone rather than a specific spot. Additionally, compartment syndrome often presents with intense pain and swelling that requires immediate medical attention.

If you think you have shin splints or are experiencing persistent pain along your shinbone, it is advisable to consult with an orthopedic physician.  They can provide an accurate diagnosis and recommend appropriate treatment options to help you recover and prevent future occurrences.

Related Links:

If you have shin splints that are not improving, the Jacksonville Orthopedic Institute and JOI rehab are here to help you.  We hope this article has helped to inform you of some things which can help you. To schedule an appointment with a JOI Foot & Ankle Specialist, please call (904)JOI-2000, schedule online, or click the link below. To schedule a physical therapy appointment, please call 904-858-7045.

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