What are shin splints?

Shin splints is a term for pain felt anywhere along the shinbone, from knee to ankle. The pain is caused by an inflammation of the muscles tendons, and bone tissue around the front of the lower leg (called the tibia or shin bone). They are common in runners and dancers, and the treatment involves rest and changing your exercise routine.

There are different types of shin splints.

Medial tibial stress syndrome: Medial tibial stress syndrome is the most common type of shin splint, and causes pain along the lower two-thirds of the inside edge of the shinbone. Medial tibial stress syndrome is an inflammation of the muscles, tendons, and bone tissue around the shinbone. It is caused by muscle strain where the muscle joins the shinbone. It gets worse when you run and improves within hours of stopping.

Stress fracture: A stress fracture is painful in one specific place in the shinbone. The pain is worse when you stand up or exercise, and it takes a while to improve afterwards. It is caused by muscle pulling on the shinbone, eventually causing the bone to crack.

Other conditions such as tendonitis and compartment syndrome can also cause symptoms like shin splints.

What are the symptoms of shin splints?

The main symptom is pain on the front of the lower leg and in the muscles on either side of the shin bone. The pain is there both during exercise and at rest.

What causes shin splints?

Shin splints are caused by overuse of lower leg muscles and bone tissue. This can be due to:

• a sudden increase in the amount or intensity of exercise
• the ankle joint rolling inwards too far as the running foot hits the ground (over-pronation) — this is more common in people with fallen arches or flat feet
• tightness of calf muscles
• running on sloping, uneven or hard surfaces
• using unsupportive footwear

Osteoporosis and smoking also make shin splints more likely.

How are shin splints diagnosed?

Your doctor will diagnose a shin splint by asking about how you’ve been using the muscles, what exercise you’ve been doing, and the location of pain. A stress fracture is confirmed by an x-ray, bone scan, MRI or CT scan.

How are shin splints treated?

You can usually ease the pain of shin splints by:

• rest
• putting an icepack on the area for 15 to 20 minutes 3 times a day
• taking an over-the-counter anti-inflammatory pain reliever, such as ibuprofen or aspirin
• stretching and massaging the calf muscles
• avoiding the activity that causes pain
• reducing the length and intensity of your exercise
• wearing supportive shoes

When you return to exercise, you should do so gradually over a few weeks. You should run on soft, level ground, and wear sturdy shoes and use insoles for arch support.

Commonly you may need to see a physiotherapist or exercise physiologist who can supervise the recovery safely especially if you lead a very active life.

If you have a stress fracture, that is usually treated with a brace, not surgery.

When should I see my doctor?

Seek medical attention right away if the pain is very severe or you have trouble walking. Contact your doctor if:

• the pain doesn’t go away or gets worse after treatment
• the pain changes or moves to a different area
• the leg has swelling that gets worse
• the shin bone is warm and red