Everything you need to know about this common but painful condition brought on by exercise.
Ever been in the middle of a run, or even a power-walk, and had to stop in your tracks because of acute shooting pains in your shins? This is a common but painful health problem known as shin splints.
But what exactly are shin splints, why do they occur and how can you prevent them? GP Dr Roger Henderson explains:
What are shin splints?
Shin splints, medically known as medial tibial tenoperiostitis, is a term that refers to pain felt anywhere along the shinbone from the knee to the ankle. It is characterised by damage and inflammation of the connective tissue joining muscles to the inner shin bone (tibia). The exact cause is unclear but one of the most common triggers is overuse, such as in people who exercise regularly and hard.
Shin splints is a term that refers to pain felt anywhere along the shinbone from the knee to the ankle.
There are several muscles that lie at the back of your lower leg and are collectively known as the calf muscles. The connective tissue responsible for attaching these muscles to the tibia is known as the tenoperiosteum, and every time the calf contracts, it pulls on the tenoperiosteum. When this tension is too forceful or repetitive, damage to the tenoperiosteum occurs – this causes inflammation and pain and the symptoms of shin splints.
Pain on the inner side of the shinbone is called medial shin splints, whereas pain felt on the outer side is called anterior shin splints.
What causes shin splints?
These most commonly occur due to repetitive or prolonged activities placing strain on the tenoperiosteum, which occurs in excessive walking, running or jumping activities (such as an increase in training or running).
Other causes of shin splints include the following:
• Flat feet
These can pull at the shin tendons and tear them very slightly.
• Poor exercise technique
Such as ‘rolling’ the feet inwards when running.
• The wrong shoes
Wearing the wrong type of shoe while running or using shoes with insufficient padding.
• Running on very hard or uneven surfaces
Athletes more commonly develop this condition early in the season following a period of reduced activity and when training surfaces are generally harder.
Shin splints symptoms
Shin splints are typically characterised by pain along the inner border of the shin. Sometimes this increases with rest (typically at night or first thing in the morning), following activities which place stress on the shin, such as walking, running, jumping and general weight bearing activity.
Shin splints are typically characterised by pain along the inner border of the shin.
In severe cases, patients may walk with a limp, although this may also reduce to some extent as they warm up. The affected area is often tender and sore to touch and the overlying skin may be inflamed and reddened. Areas of muscle tightness, thickening or lumps may also be felt in the area of pain.
How are shin splints diagnosed?
A thorough examination from a doctor or physiotherapist is usually sufficient to diagnose shin splints. Occasionally, further investigations such as an X-ray, ultrasound, bone scan, CT scan, MRI or compartment pressure testing may be used to assist diagnosis and rule out other conditions, such as compartment syndrome and tibial stress fractures.
How are shin splints treated?
Most people with shin splints heal well with appropriate treatment with a recovery time ranging from a few weeks to many months depending on the severity of injury, quality of treatment and length of time the injury has been present for.
Patients with shin splints that have been present for months may require a considerable period of treatment associated with reduced activity before full recovery occurs. In general, try to rest as much as possible from any exercise or training, and apply an icepack to the affected area for about 10 minute three to four times a day.
Most people with shin splints heal well with appropriate treatment.
Anti-inflammatory treatments, such as ibuprofen, help with pain and swelling (check with your doctor that it is safe for you to take these) and perform low-impact activities, such as swimming if you want to exercise.
Physiotherapy helps to speed up the healing process, and treatment options include deep tissue massage, joint mobilisation, arch support taping, shock absorbing insoles, crutches and exercises to improve flexibility (especially of the calf muscles), balance, strength and core stability.
How to prevent shin splints
There are a number of ways you can reduce the risk of shin splints when exercising. These are:
✔️ Always warm up thoroughly before exercising and stretch when cooling down.
✔️ Regularly stretch when exercising.
✔️ Run on smooth, flat soft surfaces whenever possible.
✔️ Use shock-absorbing insoles in your training shoes.
✔️ Reduce the intensity of your training if symptoms start to develop.