What are Shin Splints? How to Relieve this Common Runner’s Affliction

Do your shins throb and ache after your daily run? Do you have shin tenderness, sensitivity, soreness or pain that persists after beginning a new and intense physical activity? You may be experiencing shin splints, also known as tibial stress syndrome. While you may have heard of this condition, you may wonder, what are shin splints?

Despite being a common affliction among runners, anyone can experience shin splints. David Tranchita, MA, PT, OCS, CMTPT, CSCS, of Orthopaedic Hospital of Wisconsin Physical Therapy is here to describe this condition, its common risk factors, and tips on prevention and when to seek professional help. 

What Are Shin Splints?

The term “shin splints” refers to pain along the shin bone (the tibia) — the large bone in the front of your lower leg. Shin splints are common in runners, dancers, sports that involve running (soccer, basketball, etc.), and military recruits. Formally known as medial tibial stress syndrome, shin splints often occur in athletes who have recently intensified or changed their training routines. The increased activity overworks the muscles and tendons that attach to the bone. However, they don’t only occur in athletes. Anyone who starts a new physical activity too quickly or wears the wrong shoes can develop shin splints.

If you have shin splints, you might notice tenderness, sensitivity, soreness, and/or pain along the inner side of your shinbone and mild swelling in your lower leg. At first, the pain might stop when you stop exercising. Eventually, however, the pain can be continuous and might progress if not treated early and progress to a stress reaction or stress fracture.

In most cases, shin splints are treated with rest, ice, and other self-care measures. Wearing proper footwear and modifying your exercise routine can help prevent shin splints from recurring.

What Causes Shin Splints?

Shin splints are caused by repetitive stress (running hills, jumping, etc.) on the shinbone, and the connective tissues that attach your muscles to the bone.

You’re more at risk if:

• You’re a runner, especially beginning a running program or new to the activity.
• You suddenly increase the duration, frequency, or intensity of exercise.
• You run on uneven terrain (off-road/trails), running hills, running on hard surfaces (concrete), or running the same route or trail in the same direction, causing overuse.
• You’re in military training (boot camp).
• You have flat feet or high arches.

How Do I Prevent Shin Splints? 

• Analyze your movement. Formal video analysis of your running technique can help identify movement patterns that contribute to shin splints. Commonly, a slight change in your running can help decrease your risk. Your physical therapist can help with this.
• Avoid overdoing. Too much running or other high-impact activity performed for too long at too high an intensity can overload the muscle in your feet and legs.
• Choose the right shoes. Purchase your shoes at a running store, not a department store. They have staff who know shoes and will get you in the proper shoe base on your foot type. If a runner, replace your shoes about every 300 miles.
• Consider arch supports. Arch supports can help prevent the pain of shin splints, especially if you have flat or high arches. Custom orthotics from a physical therapist are more durable, last longer, and are custom for your own feet.
• Lessen the impact. Cross-train with a sport that places less impact on your shins, such as swimming, walking, elliptical, or biking. Remember to start new activities slowly. Increase time and intensity gradually. Put rest days in for recovery time.
• Add strength training to your workout. Exercises to strengthen and stabilize your legs, ankles, hips, and core can help prepare your legs to deal with high-impact exercise and sports. Your physical therapist can help design the right program.

What Are My Treatment Options?

Shin splints are usually diagnosed based on your medical history, your current activity level, which may be the mechanism, and a physical exam. In some cases, an X-ray or other imaging studies can help identify other possible causes for your pain, such as a stress fracture.

In most cases, you can treat shin splints with simple self-care steps:

• Rest. Avoid activities that cause pain, swelling, or discomfort — but don’t give up all physical activity. While you’re healing, try low-impact exercises, such as swimming, bicycling, or water running.
• Ice. Apply ice packs to the affected shin for 15 to 20 minutes for several days. Wrap the ice packs in a thin pillowcase or towel to protect your skin. 
• Take an over-the-counter anti-inflammatory or pain reliever. Try Ibuprofen such as Advil, Motrin, naproxen sodium (Aleve) for anti-inflammatory or acetaminophen (Tylenol) to reduce pain. To avoid stomach upset, make sure to eat food before taking it.

When Should I Seek Professional Help?

Consult a physical therapist if conservative treatment at home (rest, ice, and over-the-counter medications) doesn’t ease your shin pain in the first two weeks. They will utilize high-level manual therapy skills to assess and treat painful and tight muscles that cause shin splints. You will receive specific exercises to continue between therapy sessions. Once your symptoms have reduced, they may recommend custom orthotics and put you on a gradual and progressive program to get you back to normal.

If you’ve been dealing with shin pain or shin splints for two weeks with no relief, please do not hesitate to make an appointment with one of our skilled physical therapists. They will help create a custom treatment plan that will get you back to running and enjoying your daily activities without pain.