Running health expert Dr Juliet McGrattan gives us the run down on shin splint causes, symptoms and treatment tips.
By Dr Juliet McGrattan (MBChB)
The term shin splints sparks fear into the hearts of any runner who hears it. A painful condition of the shins, the condition often requires prolonged rest to resolve it. But it isn’t just runners who are affected. If you walk, jump or dance it can affect you too. So, what exactly are shin splints? What cases them and what can you do to prevent and treat them?
Award-winning author and running health expert Dr Juliet McGrattan gives us the run down on this troublesome condition including shin splints causes, symptoms and treatment options:
What are shin splints?
Shin splints is the name given to exercise-related pain and tenderness in the front of the lower legs. It can affect one or both legs. It’s also known as medial tibial stress syndrome (MTSS). The tibia is the name of the larger of the lower leg bones and the medial (inner) side is where the pain is usually felt.
Shin splints is a common condition which often stops you exercising for weeks at a time. It’s important to differentiate shin splints from stress fractures. There are no breaks or cracks of the bone in shin splints. It’s thought that if ignored, shin splints can progress to stress fractures although stress fractures can occur independently without shin splints.
What causes shin splints?
Despite medical advances and scanning techniques, we still don’t really know exactly what causes shin splints. Exercise places stress on the shins, hence the name MTSS. This causes changes in the tissues of the front lower legs but it’s unclear exactly what happens. One theory is that the repetitive and forceful tugging of muscles and tendons on the outer layer of the bone causes bleeding and inflammation which results in pain.
Shin splint risk factors
Anyone who does repetitive or prolonged exercise can get shin splints but they’re most common in runners, long distance walkers and jumpers.
You’re at particular risk of shin splints if:
- You are overweight
- You are new to exercise
- You increase your distance quickly
- You don’t allow enough recovery time after exercise
- You are a woman
- You run on hard or uneven surfaces
- You have flat feet
- You’ve had shin splints before
Shin splint symptoms
Pain from shin splints can be felt anywhere on the front lower leg from the knee to the ankle, typically on the lower, inside border of the shin bone.
Pain starts during exercise, throbs afterwards and eases with rest, however, it can progress to being a continuous pain.
It’s also common for there to be a generalised tenderness when you press over your shin bones.
Shin splint diagnosis
The diagnosis of shin splints is usually made by a doctor or physio listening to your story about the nature, type and progression of your pain and by examining your legs. X-rays won’t show shin splints because the changes are in the tissues around the bone and not the bone itself. However, your health care professional will want to feel confident that you don’t have a stress fracture or other conditions of the bone so if they are unsure they may order x-rays or other scans to help with diagnosis.
You should always seek medical advice if you have shin pain which is severe, persistent or recurrent.
Signs that you may have a stress fracture of the lower leg include:
- Sudden onset of paincompared to a more gradual onset with shin splints.
- Pain gets steadily worse with exercise and doesn’t ease up.
- Pain when you aren’t running and when you are resting, particularly pain at night.
- A tender point on the bone rather than a generalised tenderness.
- Swelling of the bone or further down around your ankle or foot.
Shin splints treatment
Thankfully most people with shin splints recover within a few weeks although it can take months if they are severe and have been present for a long time before treatment. The main treatments for shin splints include:
Rest is crucial. It can take around four weeks and you shouldn’t do the exercise that made your shins hurt until all tenderness has resolved and you are pain free when you run and jump. It’s fine to do exercise that doesn’t cause pain such as cycling or swimming to keep up your fitness levels.
Applying ice to your shins will help ease any discomfort. Wrap the ice in fabric so it doesn’t damage the skin and apply for 15 minutes three to four times a day.
Painkillers won’t speed up healing the but they will make you feel more comfortable while this process is happening. Paracetamol or ibuprofen are good choices – chat to your pharmacist about what is right for you.
Physiotherapy 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.
9 shin splint prevention tips
Thankfully there are lots of things you can do to help minimise the chance of you being affected by shin splints:
- Increase your exercise distance gradually.
- Slowly increase the number of days each week that you exercise.
- Allow at least one or two rest days per week for your bones to adapt to your training load.
- Make sure your trainers are supporting your feet well and aren’t too old and tired.
- Mix up the surfaces that you exercise on and include softer terrain such as grass, trails and the treadmill.
- Look after your calf muscles with strength exercises, regular stretching and a deep massage with a foam roller.
- Add strength training into your weekly routine to improve all over body stability and balance.
- See a sports physiotherapist to have your running style and biomechanics (way your body moves) assessed. Weaknesses can be spotted and personalised exercise plans created.
- Reduce the intensity of your training if symptoms start to develop.