Causes of shin splints

Shin splints are caused by overuse of lower leg muscles. 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.

Types of shin splints

There are different types of shin splints.

Medial tibial stress syndrome

Medial tibial stress syndrome is the most common type of skin 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 your shinbone, or tibia. 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 tendinitis and compartment syndrome can also cause symptoms like shin splints.

Your doctor will diagnose these conditions based asking about a history of muscle overuse such as the pattern of exercise, and on the location of pain. A stress fracture is confirmed by an X-ray, bone scan or CT scan.

Shin splints treatment

You can usually ease the pain of shin splints by:

• rest
• putting an icepack on the area for 15-20 minutes three times a day
• taking an over-the-counter anti-inflammatory pain reliever, such as aspirin
• stretching your calf muscles daily.

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.

This will usually fix the problem. If the pain persists, see your doctor as other causes of lower leg pain may need to be investigated.

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.