Shin Splints

Shin splints, also called medial tibial stress syndrome, is a general term used to describe a group of ‘overuse’ injuries of the lower leg.  These include inflammation of the deep calf muscles where they meet the bone, inflammation of the outer layer of the shin bone, stress fracture of the tibia of fibula, or compartment syndrome, a condition where the pressure in the lower leg builds up causing pain.  Shin splints are most frequently seen in runners, dancers, netballers, footballers and other running and jumping based sports. The pain of shin splints is typically located along the inside border of the tibia, but can also be felt in the outer part of the shin or in the calf muscles.

Common Symptoms

  • Pain along the inner border of the shin, which is typically worse with running based exercise, and eases with rest.
  • Initially pain may be felt at the start of exercise, and lessen as the session continues. In more severe cases the pain may not improve throughout the exercise session, and a constant ache may be present even after completion of the session.
  • Pain is often worse with running on hard surfaces or when running downhill
  • The inner border of the shin is often tender to touch, particularly along the lower third of the bone.
  • Pain will often return the morning after any running based exercise

Common Causes

Shin Splints are a cumulative stress injury, and are generally caused by a combination of overuse, training errors and poor biomechanics, including;

  • Overtraining in running or jumping based sports
  • A sudden increase in training volume
  • Insufficient recovery time between training sessions
  • Change in training surface to a harder surface, such as switching from grass to road running
  • Pronated feet, or feet that roll in
  • Inappropriate or worn out footwear
  • Muscle imbalances in the leg and core

Self Management

  • When starting a new exercise or training program ensure that you alternate high impact exercise such as running, with low impact options such as swimming or cycling to help prevent shin splints occurring in the first place.
  • Once shin splints have been diagnosed it is important to rest from high impact sports, and maintain fitness with low impact exercise alternative such as swimming, cycling or rowing, until the pain has improved. Continued high impact training with shin splints can not only make the pain much worse, but the recovery much longer.
  • Apply ice to the shin area twice daily for 20 minutes
  • Ensure you are wearing appropriate sports shoes that are not worn out when exercising

Physiotherapy Management

  • Perform a thorough assessment to determine the severity of the shin splints, the contributing training factors, and any underlying muscle imbalances.
  • Advise you on what training you should rest from, and suggest possible alternatives to maintain strength and fitness while recovering from the shin splints.
  • Implement a home or gym based exercise program to address any strength or flexibility issues
  • Use a number of local techniques to help reduce pain and inflammation
  • Assess your footwear, shoes and fit orthotics if necessary
  • Once you have recovered, design a management plan for the remainder of the sport season to help prevent a recurrence.