What Are Shin Splints?

Shin Splints

The majority of runners have experienced shin pain at some point. But there are several questions that need to be addressed.  

1. What are the causes of shin splints? 
2. What does a shin splint feel like?
3. What causes the pain from shin splints? 
4. Why do some people get them and some do not?
5. How do you deal with shin splints without interrupting your race schedule?

The diagram below shows the muscles involved with shin splints

Image of the muscles involved with Shin Splints

Shin Splints or Medial Tibial Stress Syndrome

The quick answer is that shin splints are defined as medial tibial stress syndrome (MTSS). It usually appears as pain at the inside border of the tibia (lower leg bone) and the muscles on the front of shin or tibia. It usually starts as pain after running and is painful to the touch. If you continue to run with shin splints, the pain can become more consistent and hurt while running or even walking. Some people report a burning sensation. Prolonged or repetitive shin splints can eventually evolve into tibial stress fractures. Stress fractures can lead even more time off of running, usually at least 6 weeks.

The muscles which are involved with Shin Splints are the Tibialis Anterior and the Extensor Digitorum Longus and Posterior Tibialis muscles. 

Image of Shin Splints

What are the Causes of Shins Splints?

Shin splints are more likely with new or inexperienced runners. Women are 2-3 times more likely than men to have shin splints. Those who have little athletic history are more likely to develop shin problems associated with running. 

Recent CT scan studies suggest the tibia of these runners have pockets of low bone density at the location of pain. Once these runners have recovered, the pockets of low bone density disappear. In contrast, those with tibial stress fractures, show larger areas of lowered bone densities around the area of the fracture. This suggests that the cause of shin splints is due to the bending of the bone while being loaded, rather than the straight-on impact.

Shins splints can occur with other activities besides running as well.  Early in the training and conditioning phase of other sports, shin splints can affect many athletes. 

In a less experienced runner, the tibia is no use to the stress placed on it from the impact of running. This results in the lack of bone formation around the area of stress. The bone remodeling takes weeks to complete, which is needed to have the bone strong tolerate the stress of running.  

Other causes of shin splints are:

1. Too much activity and too quickly
2. Poor footwear
3. Lack of conditioning
4. Muscular imbalance
5. Lack of calf flexibility
6. Changing surfaces for activity (grass, sand, concrete, or artificial turf)

Other issues from running may include:

• aching knees
• back pain
• knee pain.

 If any of these occur, it is a good idea to see a doctor or physical therapist to assess the issue. 

What Does a Shin Splint Feel Like?

Pain along the inside or outside aspect of the tibia or the shin bone.  Usually, the pain is described as achy.  The pain is present at the start of activities and then gets better.  However, the pain returns afterwards. 

How Do You Treat Shin Splints?

• Take shorter steps with running.  This is call shortening your stride for all you runners out there. Shortening the stride causes you to have less impact on the tibia bone when you run.  If you're not sure how to do this, an professional running analysis may help.  
• There is some evidence in research that a thinner shoe on a harder surface might decrease your leg stiffness. Therefore, don’t switch to a softer shoe, just yet. That softer shoe requires the lower leg to be stiffer to compensate for the ground reaction force and cushion.
• Running Compression Socks may help to support the tibia while running.
• Custom Orthotic inserts can help to decrease the impact force on the lower leg with running in some people.   

Custom foot orthotic insert

• Strengthening your calf and shin muscles may help to absorb the stress placed on the tibia. The increased muscle around the lower leg will result in increased tibial strength to reduce shin splint incidences. Try this strengthening routine.
  • Heel Walking
  • Toe walking
  • Eccentric calf raises – knee straight
  • Eccentric calf raises- knee bent
  • Standing calf raises
  • Shin exercises with a TheraBand
• Icing the area of pain for 10 to 20 minutes can help to decrease pain and swelling.  An Ice Cup can help to pinpoint the painful are as well.  Rubbing an Ice cup on the area should be done for about 7 or 8 minutes. 

Ice Cup on Shin Splints

• Calf stretching is important when managing shin splints.  Stretches should be held for at least 30 seconds 3 times. 

Calf Stretch for Shin Splints

Conclusion: What if Shin Splint Pain Persists?

 Shin splints can be very painful and frustrating to treat. Time and rest are the ultimate healers. If pain is persistent, make sure you seek assistance to diagnosis a possible stress fracture or compartment syndrome. If Shin Splints are limiting your running or participation in other sports, please give JOI a call. 

  Our website medical library has several articles on all of the injuries listed below.  Please go to JOI Library or JOI Trending.

To schedule an appointment for physical therapy at one of the 12 JOI Rehab Centers, please call 904-858-7045.

To schedule an appointment with a JOI Orthopedic Physician, call 904-JOI-2000, schedule online, or click below.