Shin Splints

Shin splints, or medial tibial stress syndrome, is the 5th most common over-use running injury. It is characterized by recurrent pain along the medial border of the tibia (shin). Symptoms typically include a dull ache that occurs without tingling or numbness. The latter are symptoms of an exercise induced compartment syndrome. Warmth and inflammation are present in some cases. Pain and discomfort typically resolve with rest.

How does it occur?
As mentioned above, this is an over-use injury caused by too much strain through the fascia that overlies the tibia and muscles in the leg. Increases in mileage, intensity, or changes in running surface have been implicated as causative factors in shin splints. An often overlooked training error is inconsistency. Runners who’s training regimen does not include regular exercise, running in particular, are more prone to injury. Biomechanical factors associated with shin splints include: tight calf muscles, over-pronation, and muscle weakness or de-conditioned leg muscles.

How is it diagnosed?
Clinical examination of the leg by a doctor is the primary diagnostic method for shin splints. X-rays, bone scans, CT, or MRI are used in some cases to rule out stress fracture.

How is it treated?
Reducing inflammation and strain are the two primary goals of treatment. Ice, anti-inflammatory medications, and rest are important. In addition, stretches and treatment of any underlying biomechanical problem are key to success resolution of shin pain. For example, inserts or orthotics may be used to control excess pronation. Shoe changes can also affect lower extremity biomechanics. Physical therapy can be used to assist in reduction of the inflammation and biomechincal causes of shin splints. Alterations to a runner’s training program are necessary for reduction in the over-use that caused the injury. Finally, injections are sometimes used to reduce inflammation in along the bone.

When can a runner return to activity?
The goal of rehabilitation is to return a runner to activity as soon as possible. If an athlete returns too quickly, the injury will heal and further time away from running will be necessary. Everyone’s injury is affected by various factors such as the duration of symptoms and your body’s anatomy. Therefore, recovery is differently for everyone and is dependent more upon your body than a specific number of weeks. Typically, the longer you have had symptoms, the longer recovery will take. When walking or jogging short distances is no longer painful, then training can be resumed. Keep in mind, this return to sport can take time and a gradual return is important with any injured runner.

What can be done to prevent shin splints?
The two factors most important for reducing the chance of shin splints are: flexibility and proper training. Training errors account for roughly 60% of all over-use running injuries. Thus, adjusting the training regimen is important. This can include: variation in the running route and terrain, adjusting training schedule, and altering shoe selection. Studies have shown varying your shoes from run-to-run can reduce injury rates. Flexibility is accomplished by proper stretching of the leg and foot muscles. Finally, and most importantly, for those who struggle with injury, a 3D gait examination can reveal biomechanical deficiencies that lead to injury.

This information is not intended to diagnose, treat, or prevent any injury or disease. It is intended to serve as an overview of running-related injuries and should not be used as a substitute for sound medical advice from a doctor or therapist.