Shin Splints

Everything you need to know about shin splints: causes, treatments, and recovery.

What Are Shin Splints?

Shin splints, medically known as medial tibial stress syndrome, are characterized by pain along the inner edge of the shinbone caused by overuse.

Diagram of leg muscles highlighting shin splints

Anatomy Involved

Shin splints affect the tibialis anterior and tibialis posterior muscles, which run along the front and inner side of the shinbone (tibia). The condition also involves the periosteum, a thin layer of tissue covering the tibia, which becomes inflamed due to repetitive stress. Overuse can lead to small tears in the muscles and tendons that attach to the tibia, compounding the pain. The posterior compartment muscles, responsible for stabilizing the ankle, are frequently involved as well.

Anatomy of the tibia and surrounding muscles

Mechanism of Injury

Shin splints, medically known as medial tibial stress syndrome, occur due to repetitive stress on the shinbone (tibia) and surrounding connective tissues. This stress is often caused by activities that involve frequent running or jumping, especially on hard surfaces. When the muscles and tendons attached to the tibia become overworked, small tears and inflammation occur, leading to pain. Improper or worn-out footwear can exacerbate this condition by failing to provide adequate cushioning or support. Additionally, biomechanical issues like flat feet, overpronation, or weak stabilizing muscles can contribute to uneven stress distribution, further straining the shin area. Athletes who suddenly increase their workout intensity or frequency are at a higher risk of developing shin splints.

Running biomechanics showing stress on the shinbone

Signs & Symptoms

  • Pain along the shinbone: The most common symptom is a dull, aching pain along the front or inner part of the lower leg, typically on both sides of the tibia. The pain may be sharp or intense, especially during physical activity like running or jumping.
  • Swelling: In some cases, mild swelling may occur in the affected area. This is generally a sign of inflammation in the soft tissues or muscles around the tibia.
  • Tenderness to the touch: The affected area will be tender when palpated, particularly along the shinbone itself. In some cases, you may feel a hard or inflamed area along the bone.
  • Increased pain with activity: The pain often worsens during physical activities that involve impact, such as running, sprinting, or jumping. This pain may subside after rest, but can quickly return with further exertion.
  • Morning stiffness: Individuals with shin splints may experience stiffness in the affected leg, especially when getting up in the morning or after long periods of inactivity.
Illustration of symptoms with markers on the shin

Grades of Injury

  • Grade 1: Mild pain that occurs during activity and typically subsides with rest. Often linked to slight overuse or improper form.
  • Grade 2: Moderate pain that occurs during and after activity, with potential swelling in the shin area. This may indicate more persistent inflammation.
  • Grade 3: Severe pain even at rest, often indicating microfractures in the shin bone (stress fractures). This requires immediate medical intervention and rest.
Chart of shin splint severity levels

Initial Treatment

  • Rest: Cease high-impact activities such as running or jumping to allow the tibia and surrounding tissues to heal.
  • Ice Therapy: Apply ice packs to the affected area for 15–20 minutes every 2–3 hours during the acute phase to reduce pain and swelling.
  • Anti-inflammatory Medications: Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, can help decrease inflammation and manage pain.
  • Compression: Use compression sleeves or bandages to minimize swelling and support the affected area.
  • Elevation: Keeping the leg elevated helps improve blood circulation and reduces swelling.
Ice pack on shin with supportive bandage

Rehabilitation

  • Strengthening Exercises: Focus on the lower leg muscles, including the tibialis anterior and posterior, to support the shinbone. Examples include toe raises, resistance band exercises, and eccentric calf raises.
  • Stretching: Stretch the calves (gastrocnemius and soleus muscles) and Achilles tendon to enhance flexibility and reduce stress on the shinbone. Dynamic stretches before activity and static stretches post-exercise are recommended.
  • Cross-Training: Engage in low-impact activities like swimming, cycling, or elliptical training to maintain cardiovascular fitness while allowing the shin to heal.
  • Progressive Load: Gradually increase running or activity volume over weeks, avoiding abrupt spikes in intensity.
Person doing calf stretches with a resistance band

Prognosis for Playing Again

  • Gradual Return: Start with low-impact activities and slowly progress to running or jumping over weeks, ensuring no pain during or after activity.
  • Pain-Free Threshold: Athletes should return to sports only when they can run, jump, and perform sport-specific movements without discomfort.
  • Preventative Measures: Incorporate regular strength training, proper footwear, and stretching routines to avoid future injuries.
Athlete running pain-free after recovery

Prevention Tips

  • Wear proper, shock-absorbing footwear suitable for your activity. Replace shoes every 300-500 miles of use.
  • Incorporate strengthening exercises for your calves and shins, such as toe raises and resistance band workouts.
  • Stretch before and after physical activity, focusing on your calves and Achilles tendons.
  • Avoid running on hard surfaces for prolonged periods; consider using softer terrains like grass or tracks.
Infographic showing prevention tips for shin splints

Real-Life Examples

  • Kobe Bryant: Basketball legend known to have dealt with shin splints during intensive training seasons.
  • Paula Radcliffe: World-class marathon runner who experienced shin splints due to repetitive strain from long-distance running.
  • Michael Phelps: Olympic swimmer who faced shin splints from cross-training activities like running during dryland workouts.
Photos of famous athletes who experienced shin splints