So, What Exactly Are Shin Splints?

“Shin splints” or medial tibial stress syndrome is a common exercise-related problem in many athletes including runners, dancers, and military recruits.  Shin splints refer to pain along the inner edge of the shinbone (tibia).

Medial tibial stress syndrome is the inflammation of the muscles, tendons, and bone tissue around the tibia.  Pain will typically occur along the inner border of the tibia where the muscles attach to the bone.  Mild swelling in the area may also occur.  Shin pain may be sharp and razor-like or dull and throbbing.  It can occur both during and after activity.  Shin splints develop when the muscle and bone tissue become overworked by repetitive activity. 

 Shin splints occur often times after sudden changes in physical activity.  These can be changes in duration and intensity, such as increases in mileage or adding in hills or changes in work-out frequency or work-out surface.  Having flat feet or abnormally rigid arches can also contribute to shin pain.  Exercising with improper or worn-out shoes are other factors in shin splints.

 Shin splints typically heal on their own. Duration and intensity of pain can be decreased by numerous treatments. 

  • Rest is the most important, since shin splints are caused by overuse.  Lower impact activities such as riding a bike, using an elliptical, or swimming can be used a substitute for active rest during recovery. 
  • Taking a non-steroidal anti-inflammatory medication such as ibuprofen or naproxen can help reduce pain and swelling. 
  • Using ice for 20 minutes at a time, several times a day will also help.  Do not apply ice directly on the skin, use a light towel or washcloth. 
  • Wearing an ACE wrap or elastic compression bandage may help prevent additional swelling, just do not wrap too tightly or it can cause increase swelling in feet. 
  • It is also helpful to do add flexibility exercises of the lower leg to help stretch the muscles and tissues. 
  • It can also be useful to get evaluated by a footwear specialist to ensure you are wearing the most correct and supportive type of shoes for the activity you do. Sometimes it is necessary to get either over-the shelf or custom orthotics if you have flat feet or recurrent problems.  Shoe inserts can help align and stabilize the foot and ankle, taking stress off of the lower leg. 

 If after trying the above for a week or two with no improvement, it may be necessary to see a sports medicine physician for evaluation with possible x-rays and physical therapy. 

 Before returning to full activity, you should be pain-free with daily activities for at least one week.  Also keep in mind that when returning to your activity of choice, it must be a lower level of intensity to start.  You should not just jump back in, exercising as often as before or for the same amount of time.  There needs to be a slow gradual increase of all factors.

 There a many things you can do to prevent shin splints. 

  • Wearing proper fitting athletic shoes is an important factor.  You need to make sure you not only proper fitting shoes but they should be designed for your sport.  Running long distances in basketball shoes is not a good idea.  If running long distances, keep track of mileage ran in each pair of shoes. They should be replaced between 350-550 miles, depending on running style, body weight, and surfacing running on. 
  • Cross training is also another important prevention factor.  Alternate running with lower impact activity such as swimming, biking, or even running in the water.

If you suspect you or your child has shin splints (medial tibial stress syndrome) please call on your SSM Health Cardinal Glennon SportsCare liaisons and they would be more than happy to help triage the problem and help navigate the healthcare system as needed.

Amanda Sullivan, MS, ATC, LAT
Outreach Liaison – Cardinal Glennon SportsCare
SSM Health Cardinal Glennon Children’s Hospital

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