Do you feel sharp pain along your shins while you are jogging or
during aerobics class? Are your shins tender and a little swollen? If your
answers are yes, it is likely that you have shin splints. You can feel the pain
of shin splints on the front, inside, or back of your leg. The term "Shin Splints"
is used to describe exercise-related lower leg pain. Shin splints involve damage
to one of two groups of muscles along the shin bone that cause pain. The
location of the shin splint pain depends on which group of muscles is damaged.
Shin Splints account for 10% to 15% of all injuries due to running exercises,
and about 60% of pain in the lower legs. It is normally in the front of
the shin, but also occurs on the inside of the shin.
The two types of shin splints include the anterolateral
shin splint - a type of shin splint that affects the front and outer part of
the muscles of the shin and is caused by a congenital (present at birth)
imbalance in the size of opposite muscles and posteromedial shin splint -
a type of shin splint that affects the back and inner part of the muscles of the
shin and is caused by running and/or by wearing inappropriate footwear.
Shin splints cause pain in the front of the outer leg below
the knee. The pain of shin splints is most often located on the outer edge of
the mid region of the leg next to the shin bone (tibia). An area of discomfort
measuring 4-6 inches (10-15 cm) in length is frequently present. Pain is often
noted at the early portion of the workout, then lessens only to reappear near
the end of the training session. Shin splint discomfort is often described as
dull at first. However, with continuing trauma, the pain may become so extreme
as to cause the athlete to stop workouts altogether. Shin splints may also be
caused by standing for a long time or repetitive stress to the lower leg.
Anterolateral shin splints
With this type of shin splint, pain is felt on the front and outside of the
shin, which is first felt when the heel touches the ground during running. Pain
eventually becomes constant and the shin is painful to the touch.
Posteromedial shin splints
With this type of shin splint, pain starts on the inside of the lower leg
above the ankle. Pain becomes worse when standing on the toes or rolling the
ankle inward. As the shin splint progresses, the severity of pain will increase,
leading to inflammation.
They can be caused by running or jumping on
hard surfaces or simply overuse. They occur most often in people unaccustomed to
training, although they can also plague experienced athletes who switch to
lighter shoes, harder surfaces or more concentrated speed work. The cause could
be one of three overuse injury conditions that develop gradually during
excessive sports activity:
Muscle Irritation - The muscles that
cover the shinbone become irritated and may cause swelling. In extreme cases
pain is felt before, during, and after exercise. This is caused by repetitive
pounding of the feet during running and sports like cross country track,
aerobics, basketball, and volleyball.
Muscle Swelling - During exercise,
the muscles of some people swell with blood more than is normal. This puts
pressure on surrounding nerves and the blood supply. Tightness, numbness, and
tingling in the lower leg are signals that a medical emergency has developed. If
left untreated, long-term loss of mobility in the leg may result.
Stress Fractures - Tiny cracks in the
lower leg bones. They may occur when muscle strength is exceeded, or when muscle
contractions bend the bones. Stress fractures are common in distance runners and
ballet dancers. People with thin bones are at greater risk. This is the most
serious and can take 6 months or more of care.
The best course of treatment for shin splints is to discontinue
any activity that is causing the condition, until the injury is healed. Other
treatment may include stretching exercises, strengthening exercises, running
shoes with a rigid heel and special arch support and in severe cases, surgery
where part of the shin bone is torn away.
Use the following general treatment guidelines if you are
diagnosed with shin splints. It is important to note that the treatment of a
stress fracture is not the same, and persistent shin pain should be evaluated by
your doctor before you begin treatment. Specialized (and costly) tests (e.g.,
bone scans) are generally only necessary if the diagnosis is unclear. Bone
scanning in this setting is helpful to detect stress fracture of the tibia bone.
Treat minor problems with RICE therapy: Rest, Ice, Compression,
Apply ice packs or perform ice massage for up to 20
minutes, three times a day.
Get the ice on quickly. Icing is most
effective in the immediate period following an injury. The effect of icing
diminishes significantly after about 48 hours.
Perform an 'ice massage'. Apply ice directly
to the injury. Move the ice frequently, not allowing it to sit in one spot.
Don't forget to elevate. Keep the injured body
part elevated above the heart while icing. This will further help reduce
swelling. A few pillows under
your leg should suffice.
Watch to clock! Ice for 15-20 minutes, never
longer. You can do more damage to the tissues, including frostbite, by icing
for too long.
Allow at least 45 minutes or an hour time
between treatments to allow the area to warm before beginning the icing
Take an anti-inflammatory medication
prescribed by your doctor.
If symptoms do not improve, get a medical examination.
Early and proper diagnosis is important for treatment and recovery.
Specific treatment for shin splints will be determined by your physician based
- your age, overall health, and medical
- extent of the condition
- type of shin splint
- your tolerance for specific
medications, procedures, and therapies
- expectation for the course of the
- your opinion or preference
Perform rehabilitation exercises (low-impact)
regularly. Swimming and cycling are excellent activities for an individual with
To lessen the risk of shin splints:
wear well-cushioned, quality running
run on soft surfaces like grass, dirt,
or exercise mats
increase the intensity of your workout
warm up before exercise and cool down
after with light stretching.
stretch the calf muscles before and
after a workout -- some research, though, is showing that this does not help.
Avoid over-striding, which can put more
stress on your shin.
check with a healthcare provider to see
if you need orthotic inserts for your shoes (mixed results).
After all your symptoms have improved, do
1 POPE, R. P., R.
HERBERT, J. D. KIRWAN, and B. J. GRAHAM. A randomized trial of pre-exercise
stretching for prevention of lower-limb injury. Med. Sci. Sports Exerc. 32:271–277,