Shin Splints
- Ajinkya Achalare
- Aug 31
- 4 min read
Updated: Sep 22
Have you ever experienced intense pain in your shins (lower legs) during running or jogging? Then you probably know what shin splints are!
Shin splints are one of the most common ailments among athletes, runners and individuals engaging in activities that involve repetitive stress on the legs. Also known as Medial Tibial Stress Syndrome (MTSS) in medical terms, shin splints refer to the pain felt along the inner aspect of the shin bone (tibia).
Although not a very concerning condition, shin splints can be painful and frustrating, often interfering with training or day-to-day physical activities. Understanding why they occur, how to treat them, and how to prevent them from recurring will be beneficial.
What exactly are Shin Splints?
It is a vague description of the pain rather than a specific diagnosis. It is used to describe pain along the shin bone resulting from repetitive stress on the bone, surrounding muscles and tendons. The pain usually develops after physical activity, especially high-impact sports like running, jogging, basketball, football or dancing.
In most cases, shin splints are caused by overuse or sudden activity after a period of physical inactivity.
Why does it happen?
Shin splints are considered an overuse injury, and multiple factors can contribute to their development:
1. Overtraining
A sudden increase in running speed or distance is a leading cause. Athletes who ramp up their training too quickly without allowing the body to are at higher risk.
2. Improper footwear
Wearing worn-out or uncomfortable shoes increases stress on the lower legs. Footwear that lacks proper cushioning or arch support causes the shin muscles to work extra.
3. Flat feet or high arches
Abnormal alignment of the foot, such as flat feet (pes planus) or very high arches (pes cavus), can disturb the biomechanical forces across the leg, putting extra strain on the shin.
4. Running surface
Hard or uneven surfaces, such as concrete or rocky trails, can amplify impact forces and trigger shin splints.
5. Muscle imbalances
Weakness in the calf muscles, hips, or core, combined with tight lower leg muscles, can lead to poor running form and excess stress on the tibia.
6. Previous injuries
Athletes recovering from ankle sprains or other lower limb injuries may alter their gait, unknowingly increasing strain on the shins.
How to know that you are suffering from shin splints?
The hallmark symptom of shin splints is pain along the inner side of the shin bone. This pain can vary in severity and typically worsens during or after exercise. Some common features include:
Dull aching pain in the front or inner part of the shin.
Pain that aggravates with activities and gets relieved with rest
Tenderness or soreness when pressing along the shinbone.
Swelling in the lower leg.
How is it confirmed?
Shin splints are usually diagnosed clinically based on specific history and physical examination.
X-rays are routinely done to rule out an obvious stress fracture.
MRI is rarely performed in chronic cases to grade the injury and guide treatment accurately. Fredericson has classified the injury on MRI as follows:
Grade 0: Normal signal
Grade 1: Periosteal oedema
Grade 2: Bone marrow oedema
Grade 3: Bone marrow oedema on both T1 & T2 sequences
Grade 4a: Signal changes in the cortex
Grade 4b: Obvious linear stress fracture
What is the treatment?
Fortunately, most cases of shin splints can be managed with conservative treatment. The primary goal is to relieve pain, reduce inflammation, and facilitate tissue healing.
1. Rest and activity modification: Avoiding high-impact activities like running, jumping allows the tissues to recover. Low-impact alternatives, such as swimming or cycling, can be substituted during recovery.
2. Ice therapy: Applying an ice pack to the shin for 15–20 minutes 3-4 times a day helps decrease inflammation and pain.
3. Pain management: Anti-inflammatory medications provide initial pain relief.
4. Stretching and strengthening: Stretching the calf muscles and strengthening the lower leg, hip, and core muscles improve biomechanics and reduce the risk of recurrence.
5. Gradual return to activity: Once pain subsides, a gradual return to sport is essential. Training intensity and speed should be increased slowly to avoid a relapse.
How to prevent it?
Prevention is always better than cure, especially for athletes who want to avoid disruptions in training. Key preventive strategies are:
Progressive training: Avoid sudden spikes in training volume or intensity. Follow the “10% rule”, which suggests increasing the speed or distance by not more than 10% per week.
Wearing the right footwear: Replace running shoes every 500–800 km (300–500 miles) to ensure proper support and cushioning.
Cross-training: Incorporate low-impact activities such as swimming, cycling or yoga to reduce repetitive stress on the legs.
Strength training: Focus on strengthening the calf muscles, quadriceps, hamstrings, hips, and core. Strong muscles absorb shock more effectively and reduce stress on the tibia bone.
Flexibility: Regular stretching of the calves, Achilles tendon, and hamstrings helps maintain flexibility and reduce tension on the shin.
Surface awareness: Whenever possible, run on softer surfaces like clay, grass or a track instead of concrete.
Listen to your body: Early recognition of shin pain and taking prompt action to rest can prevent the condition from worsening into more serious injuries like stress fractures.
To summerise…
Shin splints are a common, yet preventable overuse injury seen in athletes, runners, and physically active individuals. Paying attention to early warning signs is crucial.
Ignoring shin splints can lead to more severe injury like stress fracture, which need longer time to recover.
With the right approach, most people can recover fully and return to their sport stronger, wiser, and better prepared to avoid future setbacks.
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