Shin splints is the common name often given to pain at the front of the lower leg. Usually symptoms occur at the front inside of the shin bone but can arise from a number of causes.
We explain the symptoms, treatment and rehabilitation of medial tibial stress syndrome to cure and prevent it recurring.
Symptoms often come on gradually and consist of pain over the inside lower part of the tibia or shin bone. There may be pain at the start of exercise which often eases as the session continues only to come back worse later in the training session or afterwards.
Symptoms are often worse the next morning. Swelling or lumps and bumps felt along the inside of the bone. Occasionally in severe cases reddening of the skin over the inside of the leg from inflammation may be seen.
Other injuries which may also cause shin pain include tibia stress fracture, chronic compartment syndrome or poplitial artery entrapment.
Read more on assessment and diagnosis
Shin splints is a common term which can include a number of diagnosis or causes and is not an actual injury or diagnosis in itself. It is the name athletes often give to pain along the inside of the shin bone.
Medial tibial stress syndrome or medial tibial traction periostitis is a more accurate description of what is usually going on. The muscles of the lower leg pull on the periosteum or sheath surrounding the shin bone causing pain and inflammation. This is an over use injury resulting from increasing running mileage too quickly, excessive training on hard surfaces and running on your toes as in sprinting repetitions.
Certain biomechanical factors such as over pronation (rolling in) of the feet or tight calf muscles can increase the likelyhood of developing shin pain.
Read more on causes and prevention of shin splints.
Shin splints treatment
Treatment involves reducing pain and inflammation, identifying and correcting training errors and biomechanical problems and restoring muscles to their original condition through stretching, exercises and massage.
Apply the PRICE principles of protection, rest, ice, compression and elevation to reduce initial pain and inflammation. Apply a cold therapy and compression wrap to the painful area of the shin for 10 minutes every hour initially reducing frequency to 3 or 4 times a day as symptoms improve.
Avoid running, jumping or any other activities which make symptoms worse. Protect and support the area with a shin and calf support. A simple shin taping technique is very effective at relieving symptoms and taking strain off the lower leg.
A doctor may prescribe anti inflammatory medication such as Ibuprofen in the early or acute stage (do not take if you have asthma) and orthotic insoles to correct biomechanical problems of the foot may be prescribed. A full rehabilitation program with exercises, particularly stretching for the calf muscles is important with a very gradualy return to full fitness.
Read more on shin splints treatment & rehabilitation.
Exercises to stretch the muscles of the lower leg are important, in particular calf stretching exercises will stretch the tibialis posterior muscle which is often associated with shin splints. Calf stretching exercises should be done both with the knee straight and bent. Strengthening exercises may also be required and these include toe raises and calf raise exercises
Read more on exercises for shin splints.
If all conservative treatment fails then surgery is an option, although this is rare.