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Shin Splints: Causes, Prevention and Treatment

Shin splints are one of the most common injuries that runners face. If you've experienced the dull ache or pain in the front part of the lower leg around the shinbone, then you know how uncomfortable they can be. Shin splints most often strike beginner runners and can keep you sidelined and begging for relief. 

Check out the following information from OrthoCarolina physical therapist Shaun Riney about shin splints, what causes them and how to prevent and treat them. 

What are Shin Splints?

“Shin splints” is a broad term used to describe pain that occurs in the front of the lower leg (shin).  Often associated with physical activity or exercise, runners are prone to this issue. However, general vigorous sports activity can cause shin splints too, especially if you are just starting a fitness program.

What causes shin splints?

A variety of issues can make shin splints flare up, including tendonitis to the anterior tibialis muscle (typically felt on the outside of the front of the shin), irritation to the insertion site of the gastrocnemius muscle (on the inside border of the shin bone, increased pressure in the anterior (front) compartment of the lower leg, poor foot biomechanics or fatigue due to poorly conditioned muscles.

Increased pressure in the anterior compartment of the shin CAN be a medical emergency.  It is always a good idea to see an orthopedic physician to ensure that what you are experiencing is not anterior compartment syndrome.  If pain is accompanied by loss of function in the muscle that brings the toes up, if numbness is present, or if you notice that you are stumbling because your toe is catching during walking, see a physician immediately.

Tips for avoiding/treating shin splints

  • Prevention:  If you are starting a new exercise program such as running or walking, ensure that the shoes that you are wearing meet the demands of the exercise that you are doing.  In general, I recommend a good running shoe (with less than 500 miles of accumulated exercise) for either running or walking programs. 
  • Work on flexibility:  Before starting a running or walking program, start a comprehensive flexibility program.   A physical therapist or athletic trainer may be able to help guide you in the selection of appropriate flexibility exercises.
  • Strength:  Make sure that your leg strength is appropriate for the exercise you are doing.  In general, I recommend that my patients start a strength program 1-2 months before starting more strenuous exercises like running or walking. Again, a physical therapist or athletic trainer may be able to assist in the development of an appropriate program.
  • Footwear:  Often, we see shin splints that are related to the type of shoes that an athlete wears during practice or games.  These are difficult to treat because the shoes are appropriate for the sport.  I generally recommend that athletes that are running for practice and have shin pain wear a pair of running shoes (not cleats) during longer periods of running.  Additionally, use a padded insole in the cleats during exercises that require cleats.
  • ICE after exercise is almost always a good suggestion, even if no pain is present. 
  • Water:  Lack of adequate hydration may cause cramping in the muscles used for exercise.  Hydrate BEFORE, during, and exercise. In general, I recommend the initiation of hydration 2-3 hours prior to exercise and continuing up to one hour post.  Water or electrolyte drinks are equally effective.  Caffeine containing drinks are not an appropriate source of hydration. 

 Shaun Riney, MPT, is the Clinical Coordinator at OrthoCarolina Monroe’s Physical Therapy office. He holds a Bachelor’s degree in Sports Medicine and a Master’s degree in Physical Therapy.