Shin splints is a common lower leg injury, particularly in people who frequently run, including those with physically active lifestyles. The medical term for shin splints is medial tibial stress syndrome, which is characterized by pain that is usually felt along the tibia or shin bone.
Pain is usually experienced below the knee and either on the outside of your shin, which is the anterior tibialis or the inside of your shin called posterior tibialis. It is rare to experience pain on both parts of your lower leg. So, why do shin splints occur? Read on to find out more.
Causes of Shin Splints
Shin splints usually occur when there is repeated overuse of the leg. People who are into running, aerobics, tennis, and other high-impact sports are more susceptible to getting shin splints. The pain experienced from shin splints is often caused by a combination of inflammation along the periosteum or the outer layer of the bone and a slight tear in the muscles that surround the tibia.
Shin splints happen when the muscles and tendons don’t have enough time to rest and recover from repetitive stress. For runners, training too soon or running too much can lead to shin splints. To avoid running injuries, a less than 10 percent increase in mileage per week is recommended (1). Novice runners are more likely to increase their mileage too quickly and end up with shin splints. However, in some cases, experienced runners may also experience the same thing whenever they abruptly change their routine or how they run.
Another cause of shin splints is overpronation. Pronation is your foot’s usual stride when you run or walk. When the foot excessively rolls downward or inward toward the arch, it is referred to as overpronation.
Overpronation is often seen in people with flat feet since their posterior tibialis muscle tends to get excessively stretched on each step. For this reason, people who overpronate are more prone to muscle breakdown or injury than those who have normal pronation.
3. Tight Calf Muscles
Shin splints could also be due to tight calf muscles. People who participate in endurance sports and activities with strenuous exercises are more susceptible to getting muscle cramps or tight calf muscles. Muscle overuse is usually the main cause.
4. Worn Out Shoes
Your risk of getting shin splints increases if you continue to use old or damaged shoes when running. Worn out shoes don’t have the stability and appropriate shock absorption you need when performing high-intensity workouts or training.
5. Anisomelia (Leg Length Discrepancy)
People with leg length discrepancy have uneven leg lengths. It usually occurs during childhood years due to growth plate damage, which may be caused by certain illnesses or injuries. Having unequal leg lengths may cause problems in the biomechanics of running leading to running-related injuries, such as shin splints.
6. Running on Cambered Roads
Running on slightly tilted or slanted roads can cause strains in your legs leading to shin splints. This can significantly affect your running performance because your body constantly adjusts to uneven roads or surfaces.
Aside from shin splints, pain in the lower legs can also be due to a stress fracture. So how will you know if it’s a stress fracture or shin splints? Determining their difference is quite easy and simple. If your pain is point specific, which means that if the pain comes from a particular area of your shin and no other areas of your shin hurts, then it’s more likely for you to have a stress fracture. However, if the pain occurs all along the shin or everywhere down your shin, then you might probably have shin splints.
How are shin splints treated?
Treating shin splints is quite easy in most cases. Motion splints tend to resolve within 2-3 weeks with rest and simple home remedies, which include:
- Applying cold compresses using ice packs
- Elevating your legs
- Gently stretching your shin, calf, and heel
- Wearing compression socks
- Massaging your legs with foam rollers
- Not running until walking is pain-free
- Wearing appropriate running shoes
Non-steroidal anti-inflammatory medications such as naproxen sodium and ibuprofen can also be taken to help relieve pain and inflammation. In some people, an orthotic may be needed to properly correct overpronation. However, if pain persists after three weeks, make sure to contact a physical therapist.
Can shin splints be prevented?
In most cases, shin splints can be prevented by not overtraining, knowing when to rest and resume, not running on uneven surfaces, and using proper running shoes. Another way to prevent getting shins splints is by using compression gear. According to certain studies, wearing compression garments can help runners and athletes improve their endurance performance and other related complaints, such as muscle pain, muscle damage, and inflammation (2,3). Runners also tend to recover better and faster when they use compression garments.
Compression wear can help increase blood flow around the affected part of your shin and assist in the healing process. Professional-grade compression can help prevent shin splints along with its common symptoms, such as pain, discomfort, and swelling.
Aside from using compression garments, properly fitting running shoes, and not overtraining, there are also other steps that you can take to prevent shin splints. They include:
- Making sure to avoid exercising or running on tilted roads or surfaces
- Choosing shoes that feature shock-absorbing insoles
- Replacing your running shoes after reaching approximately 300-500 miles
- Gradually increasing your mileage or exercise intensity
- Including pre-running or pre-workout stretches in your routine
- Taking the time to warm up before any exercise or workout
- Performing toe exercises or strength training to help build the muscles in your calf
- Taking rest days to let your body heal and recover
- Avoiding any intensive exercises if you have severe muscle pain
Outlook for Shin Splints
Generally, people with shin splints have an excellent prognosis toward a full recovery. However, in certain cases, physical therapy may be required as part of its treatment.
- Running: How to Safely Increase Your Mileage | Journal of Orthopaedic & Sports Physical Therapy. (2014). Journal Of Orthopaedic & Sports Physical Therapy. Retrieved from https://www.jospt.org/doi/full/10.2519/jospt.2014.0506
- Engel FA, e. (2016). Is There Evidence that Runners can Benefit from Wearing Compression Clothing? - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27106555
- Hettchen, M., Glöckler, K., von Stengel, S., Piechele, A., Lötzerich, H., Kohl, M., & Kemmler, W. (2019). Effects of Compression Tights on Recovery Parameters after Exercise Induced Muscle Damage: A Randomized Controlled Crossover Study. Evidence-Based Complementary And Alternative Medicine, 2019, 1-11. doi:10.1155/2019/5698460
- Shin Splints - OrthoInfo - AAOS. (2012). Orthoinfo.aaos.org. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/shin-splints
- Symptoms and Causes - Mayo Clinic. (n.d.). Mayoclinic.org. Retrieved from https://www.mayoclinic.org/diseases-conditions/shin-splints/symptoms-causes/syc-20354105?p=1