If you’ve ever ramped up running or another form of exercise quickly, you may have experienced a pain in the inner part of your shins, below your knees. If this happened, then there’s a chance you’ve experienced shin splints.
Shin splints is a term used to describe pain in the front of the lower leg, below the knee and above the ankle, says Dr. Gbolahan O. Okubadejo, an orthopedic spine surgeon at The Institute for Comprehensive Spine Care, with offices located in New York and New Jersey. It happens near the shin bone, which is also called the tibia — the large bone in the lower part of your leg.
Causes and Symptoms of Shin Splints
Shin splints, known medically as Medial Tibial Stress Syndrome (MTSS), are caused by overuse, meaning that you may have increased running or other physical activity significantly over a short time period. Other people who frequently experience shin splints include dancers and military trainees. People working from home who now have more time to exercise also are experiencing shin splints due to a rapid increase in physical activity, says Dr. Jason L. Koh, chairman of the department of orthopedic surgery, director of the NorthShore Orthopaedic Institute with the NorthShore University HealthSystem and clinical professor with the University of Chicago Pritzker School of Medicine in Chicago.
When you have shin splints, inflammation occurs around the muscles, bone tissue and tendons (flexible tissue connecting muscles to bone) around the front of the tibia bone. “The constant pulling from exercise creates the inflammation and pain you feel with medial tibial stress syndrome,” says Dr. Raymond Tohme, a physiotherapist and osteopath with Centre Rehab Algotech in Montreal, Quebec.
The most common symptom of shin splints is pain or tenderness on the inside of your shin bone during exercise. The pain usually occurs in both legs, says Atlanta-based physical therapist and orthopedic clinical specialist Tyler Tredway. However, if it gets bad enough, you also may feel pain when you’re not doing any major exercise, Koh says.
Diagnosing Shin Splints
See a doctor if you find you’re regularly experiencing pain in the shin area with exercise or if the pain is getting worse. It’s also time to see a doctor if you have swelling in the shin area or it feels warm when you touch it. It’s helpful to get a diagnosis early on so you can start to do the right treatments.
Doctors diagnose shin splints with a physical exam, x-rays and occasionally an MRI. If you’ve also had a recent history of increasing your exercise, particularly with running or jumping, then that can be enough to make a diagnosis, Okubadejo says.
There are times when your doctor will want to rule out other conditions that cause pain in the shins. To help diagnose these other conditions, doctors may order imaging tests such as an MRI or a test called compartment pressure testing. These other conditions include:
— Stress fractures, which are small cracks in the shin bone caused by overuse.
— Tendinitis, used to describe when the tendons in a certain area of the body get inflamed.
Treatments for Shin Splints
If your doctor says that you have shin splints, there are a few ways you can get better:
— Rest. Take a break from your usual physical activity for a few weeks. However, you don’t have to sit still, which Koh acknowledges is hard for many athletes to do. You can still walk so long as you don’t have any pain. You also can do lower-impact activities like swimming or using a stationary bike if those are painless for you.
— Ice the affected area. Place ice where you have pain for 15 to 20 minutes at a time, then take a break for about an hour. Always have the ice pack in a towel or other cover so it’s not directly on your skin.
— Use a foam roller to massage the shin. This can provide some relief.
— Take an oral nonsteroidal anti-inflammatory medication such as ibuprofen or naproxen for pain and to help with inflammation when you need them.
— Stretch. Stretching helps to ease your shin splint symptoms. One stretch recommended by Tohme is to stand on your tiptoes for five seconds and then come down. Wait five seconds before trying this again. Repeat this five times for each foot.
— Work with a physical therapist or other exercise specialist. Physical therapists often treat people with shin splints and can tailor your treatment based on your exercise history, strength, flexibility and the way that you walk or run, Tredway says. They also can help guide you on how and when to increase your exercise and perform specific techniques to help your pain. Other health professionals who can help shin splints include a kinesiologist, who is a specialist in the way the body moves, or a running coach. You may work with this type of professional for a month or two, Tohme says. It’s OK to stop earlier if your pain is resolved. Or, you may want to continue for a longer time period if your pain continues past the one- or two-month time frame.
— Gradually return to activity. Don’t rush back into your physical activity at full intensity once you’ve had your rest period. Work with your doctor or another health professional to plan how much more exercise you can take on each week. Start gradually, and listen to your body if you experience pain again.
— Change your footwear. Poor-supporting footwear can contribute to shin splints. If you’re a runner, wear shoes geared toward running. You also may want to speak with a physical therapist or a running coach about barefoot running, or as it sounds, running in your bare feet. A similar approach is to use minimalist shoes that are very thin-soled and have areas for each individual toe. Although research doesn’t yet show a change to the injury rate with barefoot running, it does seem to change the amount of impact placed on the shin bone, Koh says. “Some of that energy is absorbed by the motion of the foot and the calf muscles,” he explains.
If you have flat feet, your doctor or physical therapist may recommend orthotics, or shoe inserts, to better support your feet. You can buy these custom-fitted or over the counter.
Preventing Shin Splints
Try the following suggestions to avoid shin splints:
— Build up your exercise gradually each week. If you’re a runner, increase your mileage by no more than 10% each week, Tredway advises.
— Take rest days to avoid overtraining.
— Vary your routine. Instead of running every day, alternate your running with biking, swimming and strength training. This helps avoid an overuse injury like shin splints.
— Include a warm up and cool down with your exercises. Make sure to do some stretching. “It’s important to stretch the muscles and tendons of the shin to minimize tension,” Okubadejo says.
— Listen to your body. If you think you might be developing shin splints, change your exercise routine to help lower inflammation. If rest doesn’t help, then see a doctor for a diagnosis. Or, if you’ve been diagnosed with shin splints and the traditional treatments don’t help, contact your doctor again to find out if there may be another cause for your pain.
— Find the right footwear. If you can, visit a running store where their trained salespeople can help identify the right running shoes for your specific needs, Tredway advises.
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Update 05/24/22: This story was previously published at an earlier date and has been updated with new information.