Shin Splints (Causes and Treatment)

by westcoastsciJun 9, 2018Anatomy, Health and Wellness, Injuries

Do you have Shin Splints?

Having “shin splints” is a common term used among runners, and is an umbrella term used to classify many different types of pain in the shin.

Having shin splints is not a specific injury, but is often used to refer to pain in the front of the shin. The American Medical Association defines shin-splint syndrome as “pain and discomfort in the lower leg. It is caused by repetitive loading stress during running and jumping.” Shin splint is a vague term used to describe shin pain because pain can occur on the inside or outside of the shin, be radiating or local pain and can be caused by injuries including; medial tibial stress syndrome, stress fractures, compartment syndrome or many other more specific injuries.

All of the injuries under the umbrella of “shin splints” are overuse injuries, caused by an excessive load placed on the shin. Shin pain is more common in runners or athletes that do a lot of jumping. Sports that include lots of running and jumping place more compressive forces on the shins, increasing the risk of shin related pain. Females and long distance runners are particularly at risk of developing shin overuse injuries. Risk of shin splints (any shin related pain) is often caused when:

Increasing Training Load
An athlete increases their training distance, intensity or duration that overloads and places too much stress on the shin

Running Surface
Running too much on hard surfaces/uneven surfaces can contribute to shin pain

Poor running shoes
A poor running shoe fit could contribute to shin pain. Running shoes that do not fit properly, have lost their cushion or are the wrong shoes for your running style can cause shin pain.

Hyperpronation (too much pronation)
Pronation is when your ankle rolls inwards (collapse of the foot arch). Too much pronation could contribute to shin pain.

Hypersupination (too much supination)
Supination is when you rollover your ankle and your ankle rolls outwards. Too much supination could contribute to shin pain

Poor running technique
Poor form and running biomechanics can contribute to shin pain, come to get an individualized running assessment so that our physiotherapy team can help you improve your running form.

Weak Muscles
Weakness in the arch of the foot, ankle, calf, hips or hamstrings could all contribute to the development of shin splints. A physiotherapist can identify and correct specific muscle weaknesses.

It is important to have a physiotherapist properly assess your shin pain to determine the specific cause, and how to best treat shin pain. Below we will go into a bit more detail on the symptoms of two common possible causes of shin pain.

Pain Radiating on the Lower Inside of the Shin?

Posterior Shin Splints – Medial Tibial Stress Syndrome

Medial tibial stress syndrome is the medical term that is used interchangeably with posterior shin splints. This type of shin pain occurs in the lower portion of the shin, on the medial side, or the side closest to the midline of the body. The pain usually extends across an area greater than 5 cm of the leg. Pain is reduced with rest and increases when running, jumping or placing any other compressive forces on the shin. The shin may also be tender to touch.

Pain Radiating on the Upper Front Portion of the Shin?

Anterior Shin Splints – Anterior Tibial Stress Syndrome

Anterior tibial stress syndrome is the medical term that is used interchangeably with anterior shin splints. The pain usually radiates in an area greater than 5 cm in the middle, upper, front portion of the shin. Pain often increases if you lift your toes up while keeping your heels on the ground.

Sharp Pain Localized on the Shin?

Stress Fractures

Shin pain can be caused by very small stress fractures along the shin bone. Stress fractures are tiny cracks in the bone. The symptoms of stress fractures include pain that is localized to one location and is usually eased with rest. The symptoms are different than medial tibial stress syndrome or “shin splints” because the pain is localized to one point. With shin splints, there is severe tenderness to touch on the bone. An MRI or X-Ray will often be requested for diagnostic purposes.

Treatment for Shin Splints

Whether your pain is caused by medial tibial stress syndrome or stress fractures, the good news is, both conditions can be treated through physiotherapy. Physiotherapy treatment may include:

Rest from the aggravating activity
Exercises and stretching programs
Massage or manual therapy
Taping
Gradual return to activity/sports program.
Addressing muscular weakness in lower limb

The goal of physiotherapy treatment for shin splints is to relieve pain and help you return to sport or activity pain-free, as well as, help address the cause of the shin splints.