Living With Shin Splints

By Lindsey Johnson

Shin splints are a relatively common injury that can cause considerable pain. Who gets them, how do you prevent them, and how do you treat them?

“Shin splints are the common term for two separate overuse conditions of the lower leg: anterior and medial tibial stress syndrome. Anterior tibial stress syndrome will produce pain along the front portion of your shin bone; medial tibial stress syndrome will produce pain along the inside portion of your shin bone,” said Kyle Proctor PT, DPT, a board-certified clinical specialist in orthopedic physical therapy at UF Health Rehab Center in Haile Plantation.

The pain runs between the knee and ankle, and it can feel excruciating during exercise. The pain often subsides when activity is stopped, but in more severe cases, it may continue while at rest.

How common are shin splints?
According to Medical News Today, shin splints account for approximately 10.7% of injuries
in male runners and 16.8% in female runners. Shin splints impact other types of athletes as well, accounting for up to 22% of injuries in aerobic dancers. Military recruits also experience shin splints often, due to difficult training, carrying heavy load and traveling long distances.

What causes shin splints?

Shin splints result from excessive strain over time of high impact activities, such as running, jumping and dancing. The lower part of the body absorbs the impact and the muscles, bones and tendons become overworked and inflamed, causing pain in the shin.

“The mechanism of injury is a combination of a few things, but excessive loading at too quick of a rate with running-associated activities is generally the most common. The lay term is “the terrible toos”: too much, too fast, too soon, too hard, too long. Poor running biomechanics and lower body muscle strength also plays a role in the development of these conditions,” Proctor explained.

What are the complications?

“Over time, these conditions can advance to stress fractures
if unmanaged. I advise seeking a medical opinion from a sports orthopedic physician for evaluation of your pain,” Proctor said.

According to the Mayo Clinic, stress fractures are small cracks in a bone. Cleveland Clinic states that stress fractures in the tibia or shin bone account for somewhere between
20% – 75% of all stress fractures. While stress fractures often heal on their own, they can lead to arthritis, increased risk of future stress fractures and even surgery if they are not properly treated.

What is the treatment for shin splints?
According to Proctor, most orthopedic physicians “will prescribe a period
of relative rest followed by physical therapy to address muscle weakness and flexibility issues, running biomechanics issues, and develop a return to a running program once the symptoms have subsided.”

Physical therapists will develop a tailored plan for each patient but “general recommendations for shin splints are strengthening exercises for the hips, thighs and calves to make sure the patient has good muscle strength and endurance,” Proctor said. He explains he often starts patients on exercises like squats, deadlifts, lunges, split squats, bridges and calf raises, depending on their individual ability.

Should I stop exercising?

If you are experiencing shin splint pain, your doctor will likely advise you to avoid exercises, such as running or jumping that exacerbate the pain. Proctor advises that “other cardiovascular and strengthening exercises and continuing to be active is perfectly fine and encouraged as long as it is pain-free.” Staying active is an important part of overall health and healing, but activities should be modified so that it does not cause pain.

How do I prevent shin splints?

Prevention is always the best treatment. Starting any new exercise program in a slow and controlled manner will help prevent injuries as your body adapts to new activity. In terms of running, Proctor advises, “having a well-structured running program that is not making aggressive jumps in mileage or pace. Most current research points to the 10% rule where you do not make increases of more than 10% of your running duration each week.”

As the saying goes, slow and steady wins the race! Prepare your body
for long-term success by easing into new activities or programs to avoid injury. If you experience shin splints, resist the urge to push through the pain. Allow your body to heal with ice, anti-inflammatories and relative rest. If pain persists despite self-care treatment, consult a physician for a full evaluation of your pain.

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