The term “shin splints” has become sort of a catch-all term for pain below the knee that often plagues athletes. As a runner myself, I have found this loose definition to be confusing and unhelpful. For this reason, I decided to put together this guide to everything you ever needed to know about shin splints.
This pain can occur either on the front outside of the leg or on the inside of the leg, and it is often experienced by runners and other athletes who repeatedly pound the ground with their feet.
Shin splints can also be called medial tibial stress syndrome (MTSS), and the pain can be debilitating. If you have been experiencing pain below the knee and around your shinbone, you could very well be suffering from shin splints.
Everything about Shin Splints
If you have shin splints, rest assured that you are not alone. This is one of the most common sports injuries, and it can develop in just about anyone who does too much hard exercise too fast.
Common Signs and Symptoms
Shin splints can cause a variety of different symptoms. You do not have to experience all of these signs in order to be diagnosed with the condition. Common symptoms include:
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- a dull ache in the front part of your lower leg
- pain in your leg that develops during your exercise
- pain on either side of your shin bone
- muscle pain in your lower leg
- pain, tenderness or soreness in the inner area of your lower leg
- mild swelling in your lower leg
- numbness or weakness in your feet
If you experience severe pain, you need to see a medical professional. More dire symptoms include:
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- severe pain in your leg after an accident or a fall
- heat coming from your lower leg
- a visibly inflamed shin area
- moderate to very noticeable swelling in your shin
- shin pain even when you are sitting or resting
You may find that your leg pain lessens or goes away when you stop exercising. This is a common function of shin splints. If the pain continues even when you are no longer active, you may have a more severe injury, such as a stress fracture.
Causes of Shin Splints
Runners are most at risk for shin splints because of the repetitive motion and the impact of running. If you increase your workout suddenly rather than working up to the exercise or if you change your usual running surface, you are more likely to experience shin splints.
However, you can still get shin splints even if you are not a regular runner. Some other common causes of this injury include:
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- overpronation or flat feet
- inadequate stretching or lack of flexibility
- worn-out shoes
- excessive stress on your legs
- imbalance between the strength of your calf muscles and the strength of the muscles in the front of your leg
- weakness in the stabilizing muscles of your hips or core
- previous history of shin splints
- sudden increase in the frequency, duration or intensity of your training
As a general rule, you should not increase your workout or training practices more than 10 percent in a given week. Exceeding this limit, no matter your form of exercise, will make you more likely to damage your legs and to experience shin splints.
You are also more likely to damage your shins when your tendons and leg muscles are tired. If you are on your feet for most of the day, even if you are not directly exercising, your leg muscles become fatigued and are unable to support themselves, leading to this type of damage.
The Diagnosis of Shin Splints
Most doctors and physicians will give you a physical exam in order to determine whether or not your pain is from shin splints. You will be asked about your recent physical activities, your level of participation and your frequency of activity. These questions can indicate whether or not you are suffering from an overuse injury like shin splints.
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If your doctor suspects shin splints but cannot make a determination based on the physical exam, he or she may prescribe further diagnostic testing. This typically includes imaging scans.
Most doctors will begin with an X-ray to show possible damage to your shin bone. If more problems are suspected in your tendons or your muscles, an MRI may also be prescribed.
Similar Leg Problems That are Not Shin Splints
Just because you have shin pain, it does not mean that you automatically have shin splints. In fact, there are some other possible causes for your discomfort.
Compartment syndrome occurs on the anterior, or outside, part of your lower leg. You will notice that your muscles become swollen in a specific area, creating pressure and pain in your leg. This pressure builds up as you exercise, and it usually subsides slowly after you stop.
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The more common alternative to shin splints is a stress fracture. If you have this type of break, there is an incomplete crack in your bone. While your leg is not technically broken, the stress fracture is a serious injury that should not be ignored. Your doctor will find a stress fracture on an X-ray or on a bone scan, and this pain is very localized in the area where the crack is located.
You can tell the difference between shin splints and a stress fracture first thing in the morning. If your bone feels better in the morning, it is probably a stress fracture because it has rested all night. Shin splints hurt more in the morning because your tendons and soft tissues have had all night to tighten.
How to Treat and Get Rid of Shin Splints
Once you know that you have shin splints, you need to turn your attention to the process of treating and getting rid of this painful affliction.
1. Get Some Rest
The best way to get rid of shin splints is to rest. You need to completely stop running or doing your damaging physical activity to give the bones, muscles and tendons time to heal and to stop hurting.
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The length of time for your rest really depends on your injury and on your pain level. You may need to stop until the pain is gone. While you are resting your legs, make sure to apply ice for 20-30 minutes every 3-4 hours for at least a couple of days. You can also take some anti-inflammatory painkillers to help with the pain and swelling.
If you cannot force yourself to rest and you feel like you must continue your normal running or other exercise routine, wrap your leg in a neoprene sleeve, Ace bandage or medical tape. Start the wrap just above your ankle, and continue it all the way up to the area just below your knee. This will help to stabilize your muscles and tendons to prevent added stress on them while you heal.
2. Stretch and Loosen Your Muscles
Because your shin splints may be caused by inflexible muscles, you need to carefully stretch yourself throughout your exercise routine.
If you have medial shin splints, you need to focus your stretching on your Achilles tendon. However, if your pain seems to be anterior, work on loosening your calves.
One of the best stretches you can do for your shin splints is to kneel on the floor. Choose carpeting for more comfort for your knees and ankles. Keep your legs and feet together, and point your toes straight backward. Slowly sit taller, leaning back on your calves and heels until your ankles are straightened. Hold this position for 10-12 seconds, then relax and repeat the motion.
Another option for strengthening your ankles and shins is to sit on a chair and trace the alphabet with your toes. Go through all 26 letters with each foot.
You could also try walking on your heels for 30 seconds before switching to 30 seconds of normal walking. If you repeat this process four times in a row, up to three times a day, you will have looser muscles and tendons.
3. Change Your Activities Temporarily
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If you cannot bring yourself to take some time off from your exercise routine, try to switch your methods with another form of exercise. For example, if running is what damaged your shine bones, try cross-training in the pool or on a bicycle instead. Pick up yoga or another form of exercise so that you can do your workout without damaging your legs even more.
You may find that there is another type of exercise that you like just as well as your injury-causing activity. Alternating exercise methods, even when you are healthy, is a great way to avoid damage and overuse injuries.
4. Try to Lose Some Weight
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If you are a little bit overweight, you are putting extra pressure and stress on your bones and muscles every time you exercise. Of course, that exercise can help you lose some of the weight, but you should also be aware of your diet.
Switching to leaner meats, whole grains and fresh fruits and vegetables can help you lose some of the extra pounds, making your body mass less painful for your legs. In addition, overweight people often have flatter feet and have a tendency to overpronate their ankles. Dropping some of your weight could also help you eliminate these common causes for shin splints.
5. Ease Back into Your Workout
When you are ready to begin your running or other more vigorous exercise again, ease into it slowly. If you start back up at the same level at which you stopped, you will be overdoing it, and you will face another injury. Instead, increase your frequency, duration and intensity slowly, at no more than the recommended 10 percent each week.
Make sure that you are also wearing proper shoes for your foot type, especially if you are an overpronator or if you have flat feet. Consider having more than one good pair of shoes and alternating them to vary the amount of stress you experience on your legs. Always tie them tightly to give you more stability, and consider getting assistance from a shoe professional to find the right style and fit for you. Check out our article about best running shoes for shin splints.
Prevention is the Best Medicine
Of course, the best way to heal shin splints is to never get them in the first place. Be sure that you always warm up before your exercise and that you stretch well afterward. Increase your workout slowly, and always wear proper shoes for your activity. Strengthen your legs slowly, and you are more likely to avoid this type of injury.
It can be as difficult to know when your shin splints are healed as it is to definitively diagnose the condition. When you have regained flexibility and strength, and when you can resume your usual exercise activities without pain, you are most likely healed.
Keep in mind that every body heals at a different rate, and it is not unusual for it to take 3-6 months for your shin splints to disappear. The most important thing you can do is not to rush back into your activity too quickly; you do not want to injure yourself more permanently.
If you have questions about shin splints that have not been covered here, feel free to leave a comment below.