What are shin splints?

Shin splints are pain in the lower leg due to repeated stress on the shin bone (tibia). It is also known known as tibial stress syndrome.

Shin splints are common in athletes such as runners and dancers. It is one of the most common causes of lower leg pain caused by exercise.

Your tibia (shinbone) is found at the front of your lower leg. It runs from your knee to your ankle.

What are the different types of shin splints?

There are 2 main types of shin splints, depending on which area and muscles of the shin are affected.

• Medial tibial stress syndrome (MTSS) is the most common type of shin splints. It causes pain along the inner edge of the shinbone. It is usually due to inflammation in the muscles, tendons and bone tissue around the tibia.
• Anterior tibial stress syndrome causes pain along the front of the lower leg. It is often related to the muscles attached to the front of the tibia.

What symptoms are related to shin splints?

Both types have similar symptoms, but the location of pain differs. MTSS affects the inner shin and anterior shin splints affects the front.

The pain is usually:

• dull and aching
• gets worse with activity
• improves with rest

The painful area may also be swollen and sore to touch.

What causes shin splints?

Shin splints are caused by repetitive stress and strain on the muscles, tendons and bone tissue around your shinbone. This can be due to:

• a sudden increase in the amount or intensity of exercise
• repeated impact, especially in high-impact activities like running, jumping or sports with sudden starts and stops
• issues like flat feet, excessive pronation (inward rolling of the foot) and differences in leg length
• weak or tight muscles in the calves, hips or core muscles
• running on uneven or hard surfaces
• using unsupportive shoes

These factors cause repetitive stress, leading to inflammation and pain in the shin area. It can worsen over time if left untreated.

How is the cause of shin splints diagnosed?

Your doctor will diagnose a shin splint by examining you and a review of symptoms and activity history. Your doctor may ask you about:

• recent changes in your exercise routine
• your type of footwear
• the type of pain you have
• the location of your pain

If your doctor is worried that something else is causing your pain such as a stress fracture, they may order tests, such as:

• x-ray
• bone scan
• MRI scan
• CT scan

When should I see my doctor?

Contact your doctor if you experience symptoms of shin splints.

How are shin splints treated?

Treatment for shin splints typically includes self-care methods, medicines and physiotherapy.

Self care

Self-care is often the first step in treating shin splints. You can usually ease the pain of shin splints by resting. You can also:

• put an icepack on the area for 15 to 20 minutes, several times a day
• do stretching exercises for the calves and lower legs
• wear supportive footwear, adding shock-absorbing insoles may help relieve stress on the shins
• avoid the activity that causes you pain

Medicines

Over-the-counter pain-relief medicines may help. Anti-inflammatory medicines may help manage pain and reduce inflammation.

Other treatment options

You can see a physiotherapist or exercise physiologist for your shin splints. They can guide you through exercises to improve strength, flexibility and running form. Orthotic devices or shoe inserts may be prescribed to correct foot mechanics.

If self-care and medicines don't fully relieve shin splints, there are other therapies that might help. These options include:

• ice massage
• ultrasound therapy
• iontophoresis (using a small electric charge to deliver medication through the skin)
• phonophoresis (using ultrasound to help deliver medication)
• periosteal pecking (a type of needling technique)
• shockwave therapy

What are the complications of shin splints?

The pain from splints can hinder your movement and stop you from being active. Sometimes, shin splints may worsen and lead to a stress fracture in the shin bone.

Can shin splints be prevented?

You can prevent shin splints by reducing repetitive stress on the shin bone before symptoms appear. You can also try preventing shin splints by:

• wear well-fitting shoes
• use shock absorbing insoles
• warm up before physical activity, and cooling down afterwards
• exercise at a pace appropriate for you
• allow yourself to recover after exercise

Resources and support

• Sports Medicine Australia provides information about shin pain.
• Sports Medicine Australia also offers sport-specific fact sheets on injury prevention.
• Department of Health, Disability and Ageing provides physical activity and exercise guidelines for all Australians

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.