An Overview of Shin Splints

Shin splints (called medial tibial stress syndrome) is a common condition among athletes that causes sharp or dull pain over the front of the shin bone (called the tibia) that often limits a person's ability to walk or run. 

The diagnosis of shin splints is made through a medical history and physical examination. Imaging tests may be ordered to confirm the diagnosis or rule out alternative diagnoses like a stress fracture of the shin bone.

Treatment is conservative and involves rest followed by activity modification. Ice, taking an anti-inflammatory medication, and physical therapy may also be helpful.

Cause

At the root of shin splints are microfractures (tiny breaks in the shin bone) and inflammation of the tissue that surrounds the shin bone. These tiny breaks and inflammation occur as a result of the leg being overworked by repetitive activity.

Classic repetitive activities that trigger shin splints include running, dancing, and military training.

Symptoms

The primary symptom of shin splints is pain along the border of the tibia bone (often described as sharp, dull, or throbbing). This pain is usually felt during and after physical activity. Mild swelling may also be present, and the shin is often sore to touch.

Diagnosis

If you have shin pain, your healthcare provider will perform a medical history and physical exam. In some instances, your healthcare provider may order one or more diagnostic tests.

Medical History and Physical Examination

In addition to reviewing your symptoms, especially the specifics regarding your pain (e.g., location, intensity, and what makes it better or worse), a physical examination that focuses on muscle palpation, range of motion, and strength can help your healthcare provider make a diagnosis of shin splints.

Diagnostic Tests

Diagnostic tests are mostly ordered to rule out alternative diagnoses, such as a stress fracture, tendinitis, or rarely, bone cancer.

• X-ray: An x-ray may be done to rule out a fracture in your shin bone.
• Electromyographical (EMG) testing: An EMG may be done to check on how your leg's nerves are functioning.
• Magnetic resonance imaging (MRI): An MRI shows pictures of the soft tissue around your lower extremities and can show which muscles may be injured and causing your pain.
• Ultrasound: An ultrasound can check your lower leg for blood clots which may be causing your pain.

Treatment

The treatment of shin splints involves rest (often several weeks of taking a break from the inciting activity that caused the pain), as well as these basic therapies:

• Ice the Area: Apply ice over your shin several times a day for no more than 15 to 20 minutes at a time
• Take an anti-inflammatory medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can soothe pain and reduce swelling and inflammation (be sure to only take an NSAID under the guidance of your healthcare provider)
• Wear supportive shoes: Shoes with proper cushioning can ease stress in your shins; some people may even benefit from orthotics

Physical Therapy

Physical therapy may also be part of your treatment plan for shin splints.

The goals of physical therapy are to manage the inflammatory process in your anterior tibialis muscle in the front of your shin and to work to change the biomechanical faults that may be causing your shin splints. 

These goals can be accomplished through many different strategies, including:

• Anterior tibialis stretching exercises
• Kinesiology taping to your anterior tibialis
• Strengthening exercises for your shin and ankle
• Hip strengthening exercises
• Calf stretching exercises

Prevention

There are several things you can do to prevent shin splints, such as:

• Wear a supportive, cushioned shoe that fits your foot properly (whether you have a flat foot or a high-arch)
• Alternative your activity—so instead of running every day, for instance, switch it up with swimming or cycling
• Do not overdo it—increase your running or other exercise regimens slowly and gradually (if you experience pain, stop the activity)

A Word From Verywell

If you develop pain in the front part of your lower leg that occurs with walking or running, you may have shin splints. However, there may be other causes of lower leg pain, so be sure to see your healthcare provider.

Once a proper diagnosis is made for your condition, the correct treatment can be started and you can be on the road to a speedy recovery and future prevention.