Shin splints describe pain in the front of your lower leg – i.e., at the shin bone. Formally, sports medicine doctors refer to this condition as medial tibial stress syndrome (MTSS).
The incidence of shin splints is particularly common in people who perform strenuous physical activity. Aside from intense exercises, sports that have a stop-start pattern, such as racquetball, soccer, basketball, and tennis, increase the risk of injury.
In some cases, the pain is severe enough to immobilise you. Researchers believe that this condition has a cumulative nature. Differently put, repeated stress on the muscles, joints, and bones of the lower legs will ultimately cause shin splints.
In this article, we will cover everything you need to know about shin splints, including the clinical presentation, diagnosis, and treatments.
The causes of shin splints
The leg pain triggered by shin splints is the result of months/years of repetitive micro-injuries that damage:
Connective tissues that connect everything together
The final result is inflammation and edema (i.e., swelling) of the muscles, which increases the pressure against the shinbone.
In certain cases, bone fractures could trigger stress reactions that lead to shin splints. Stress fractures do not have to be very pronounced. They often start with tiny cracks that eventually precipitate a large-scale inflammatory process.
Fortunately, giving your body enough rest will heal these cracks, which dampens the inflammation.
The risk factors of shin splints
As we already established, there are several activities and conditions that increase the risk of shin splints, including:
Flat feet and other anatomical abnormalities
Weak muscles of the lower body (e.g., thighs, buttocks)
Poor articular range of motion
Improper training techniques
Running long distances on hard surfaces (e.g., concrete)
Improper running technique
Wearing inappropriate shoes
Stop-start sports (e.g., soccer, basketball)
Scientists found that shin splints are more common in individuals with fatigued leg muscles and tendons.
Some careers that increase the risk of shin splints include:
Signs and symptoms of shin splints
When you develop shin splints, you can expect the following signs and symptoms:
Achy pain located in the front of your lower leg
Exacerbated pain during exercise
Myalgia (i.e., muscle pain)
Soreness along the inner part of the lower leg
Edema of the lower leg
Weak, numb feet
While these symptoms can be serious, they usually respond to common treatments. However, a small set of patients develop the following symptoms:
Severe pain along the shin bone, especially after a traumatic event
Feeling that your shin is unusually hot
Extensive edema becomes is visible
Shin pain even when you are resting
These signs and symptoms may be an indication of a severe complication.
How to diagnose shin splints?
The diagnosis of shin splints is typically made after taking your medical history and performing a physical exam.
Your doctor will ask you about the type of activities you engage in, their intensity, and frequency.
In case of doubt, your physician may order imaging tests, such as X-rays. The utility of these tests is to exclude fractures and other serious conditions (e.g., compartment syndrome).
The treatment options for shin splints
The first step to take after getting shin splints is taking a break from physical activities. This will allow your legs to heal by upregulating the metabolic cascades that repair bone tissue loss and muscle inflammation.
Typically, the pain associated with shin splints resolves within a few hours/days after resting.
Doctors recommend keeping your activity light for 2 weeks. During this time, you can perform low-impact exercises, such as walking and swimming.
Here are some tips to help you treat shin splints:
Elevate your legs above heart-level
Apply ice packs on the swollen area (avoid direct contact with the skin)
Take some anti-inflammatory drugs (e.g., ibuprofen, naproxen)
Use a foam roller to massage your shins
Wear elastic compression bandages
Before engaging in any activity, make sure to speak with your doctor. Additionally, avoid working out without warming up first.
Surgery is a rare option to treat shin splints. However, if you develop severe pain that does not respond to conventional treatments, it may be necessary.
The surgery to treat shin splints is known as a fasciotomy. Your doctor will make tiny cuts in areas surrounding your calf muscles. As a result, symptoms of pain and edema resolve.
How to prevent shin splints
Preventing shin splints completely may not be possible. However, you can lower your risk of this injury dramatically by following these tips:
Wear shoes that offer good support
Avoid exercising on hard surfaces
Use shock-absorbing insoles
Make sure to increase the intensity of your exercises gradually
Warm up properly before exercising
Learn some stretches that involve the lower body
Lift weights to strengthen the calf muscles
Stop exercising if you start to feel unusual pain
When planning a fitness program, ensure that most muscle groups are getting engaged instead of placing all the pressure on specific muscles. The American Academy of Orthopedic Surgeons (AAOS) also recommends the progressive return to physical activity.
When should you see your doctor?
The need to visit your doctor depends on the severity of your pain and whether you can walk.
Here are some scenarios that make you want to see your doctor:
Severe pain that does not improve
Pain that lasts for several weeks
Migrating pain – it moves from one area to another
Progressive swelling that involves other areas
Warm shinbone – this could be an indication of compartment syndrome
Optimally, you would start by seeing a primary care physician who will refer you to a specialist if needed.
Shin splints, or medial tibial stress syndrome (MTSS), is a common injury that causes leg pain. Learning more about this condition will help you identify, manage, and prevent it in the future.
We hope that this article managed to explain MTSS, its symptoms, and treatments.
If you have questions about shin splints, please feel free to share them in the comment section below. We also encourage sharing stories about this condition.