Shin Splints are the name given to pain at the front of the lower leg. It’s an overuse syndrome involving the leg muscles that stabilize and move the ankle and foot. During the first injury, the muscle fibers tear from their periosteal attachment surface. During the healing phase, they can become fibrotic which makes the area less resilient than normal muscle attachments. During further uses, they fail to lengthen properly which causes exponential increases in tension on the attachment and a repeat of the injury. Proper treatment will break down the fibrous tissue making the muscle behave more like a rubber band than a rope as it lengthens to the end of its range of motion.

Causes of Shin Splints

There are two main causes of shin splints.  The first is “overload” or training errors and the second is “biomechanical inefficiencies.”

  • Shin splints are commonly associated with sports that require a lot of running or weight bearing activity.  However, it is not necessarily the added weight or force applied to the muscles and tendons of the lower leg but rather the impact force associated with running and weight-bearing activities. When the muscles and tendons become fatigued and overloaded, they lose their ability to adequately absorb the damaging shock force.
    • Other causes of overload include:
      • Exercising on hard surfaces, like concrete
      • Exercising on uneven ground
      • Beginning an exercise program after a long lay-off period
      • Increasing exercise intensity or duration too quickly
      • Exercising in worn out or ill fitting shoes
      • Excessive uphill or downhill running
  • The major biomechanical inefficiency contributing to shin splints is flat feet.  Flat feet lead to a second biomechanical inefficiency called overpronation (flat footed). Pronation is when the foot and ankle rolls inward causing over stretching of the muscles of the lower leg.
    • Other biomechanical errors include:
      • Poor running mechanics
      • Tight, stiff muscles in the lower-leg
      • Running with excessive forward lean
      • Running with excessive backwards lean
      • Landing on the balls of your feet
      • Running with your toes pointed outward
      • Running on worn-out footwear
      • Running on tilted surfaces
      • Engaging in sports with frequent starts and stops such as basketball and tennis

Symptoms of Shin Splints

  • Pain over the inside lower half of the shin
  • Pain at the start of the exercise that often eases as the session continues
  • Pain often returns after activity and may be at its worse the next morning
  • Sometimes swelling may be present
  • Lumps and bumps may be felt when feeling the inside of the shin bone
  • Pain when the toes or foot are bent downwards

Treatment of Shin Splints

Treatment for shin splints is as simple as reducing pain and inflammation, identifying training and biomechanical issues which may have helped cause the injury initially, restoring muscle to their original condition and gradually returning to training.

  • See a sports injury specialist on recommendations for treatment and rehabilitation
  • Apply ice to the shin bone every few hours in order to reduce inflammation.
  • Apply Active Release Technique (ART)
  • Avoid activities that cause pain, swelling, and discomfort
  • Have your running style checked by your doctor and point out any habits that are causing you pain
  • Wear proper shoes: Your doctor may recommend shoe that is especially suited for your foot type, your stride, and your particular sport
  • Stretch the muscles of the lower leg
  • Strengthen and condition the muscles of the lower leg
  • Avoid running on cambered roads
  • Incorporate rest into any training programs
  • Gradual progression of training program
  • Be evaluated for custom orthotics
  • Practice swimming, pool-running, or cycling (low gear)

  Common Conditions Treated > Shin Spints >  Foot Pain