What Is a Shin Splint?

Shin splints (medial tibial stress syndrome) are a common "overuse injury" suffered by runners, dancers, other athletes and military personnel. Severe pain is the result of stress on the tibia and the connective tissues that hold the muscle to the bone. The pain may be bad enough to cause an athlete to halt a workout. Treatment is straightforward, and activity can be resumed once the injury has healed. Proper precautions should be taken to ensure that the injury does not reoccur.

Symptoms

Shin splints cause pain and soreness along the inside of the lower leg. The pain may be worse at the beginning of a workout and ease as exercise continues, or it may be continuous. Other symptoms include mild swelling or knots along the shinbone, tenderness along the shinbone and occasional redness.
Shin splint pain usually starts out dull, but can be severe enough to interfere with exercise. The pain generally covers an area 4 to 6 inches in length.
Seek medical care if severe pain in your shin results from a fall or injury, if the shin is hot or inflamed, if swelling is severe or if shin pain persists, even during rest.

Causes

Shin splints are a result of strain on the shinbone and connective tissues that hold the muscle to the bone. Common causes of shin splints include improper or worn-out footwear, running downhill or on a slanted surface, high-impact exercise and frequent stops and starts (as in basketball or tennis). Shin splints usually appear when the frequency, intensity or duration of an exercise program is increased too quickly.

Diagnosis

Shin splints are often diagnosed during a physical examination. The health-care professional will review the patient's physical history, ask about exercise and physical activity and examine the area of discomfort. X-rays may be used to rule out other injuries.

Treatment

Ice and anti-inflammatory drugs can be used to reduce swelling and ease pain in the affected leg. High-impact exercise should be avoided until the injury heals. Lower-impact exercises such as biking and swimming can help athletes stay in shape while the injury heals. Wrapping the affected shin in an elastic bandage or a specially designed compression sleeve may help ease pain, reduce swelling and improve blood flow to the site of the injury. Exercises that stretch and strengthen the muscles of the lower legs and ankles may speed healing and reduce the chances of re-injury. Once shin splints have healed, physical activity should be resumed gradually to avoid re-injury.

Prevention

People who participate in high-impact activities such as running, jumping and dancing should always stretch and warm up before a workout. Stretching the muscles of the lower legs and ankles is particularly useful in avoiding shin splints.
Proper footwear should be worn. Inappropriate or worn-out footwear can contribute to the development of shin splints. For people who have flat feet or recurring shin splints, orthopedic inserts may be recommended.
When running long distances, flat, soft terrain is easiest on the legs. Running on a hard surface or up and down hills can cause or aggravate shin splints.
Increase your physical activity gradually when beginning a new exercise regime or increasing the intensity of your workouts.
If you notice pain in your shins, do not try to "work through" the pain. It will only get worse, and your recovery will take longer.