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Description

Shin splints occur when you have pain in the front of your lower leg. The pain of shin splints is from the inflammation of the muscles, tendons, and bone tissue around your shin. Shin splints are a common problem for runners, gymnasts, dancers, and military recruits. However, there are things you can do to heal from shin splints and prevent them from getting worse.

Causes

Shin splints are an overuse problem. You get shin splints from overloading your leg muscles, tendons or shin bone.

Most often, the activity that causes the injury is high impact and repetitive exercise of your lower legs. This is why runners, dancers, and gymnasts often get shin splints. Common situations that cause shin splints are:

• Sudden change in activity level, whether it is in intensity or duration
• Running, especially on hills. If you are a new runner, you are at greater risk for shin splints.
• Increasing your days of training.
• Increasing the intensity of training, or going a longer distance.
• Doing exercise that has frequent stops and starts, such as dancing, basketball, or military training.

You are more at risk for shin splints if you:

• Have flat feet or very rigid foot arches.
• Work out on hard surfaces, such as running on the street or playing basketball or tennis on a hard court.
• Do not wear the proper shoes.
• Wear worn out shoes. Running shoes lose over half of their shock absorbing ability after 250 miles (400 kilometers) of use.

Symptoms

Symptoms include:

• Pain in one or both legs
• Sharp or dull, aching pain in the front of your shin
• Pain when you push on your shins
• Pain that gets worse during and after exercise
• Pain that gets better with rest

If you have severe shin splints, your legs may hurt even when you are not walking.

Decrease Your Activity

Expect that you need at least 2 to 4 weeks of rest from your sport or exercise.

• Avoid repetitive exercise of your lower leg for 1 to 2 weeks. Keep your activity to just the walking that you do during your regular day.
• Try other low impact activities as long as you do not have pain, such as swimming, elliptical machine, or biking.

After 2 to 4 weeks, if the pain is gone, you can start your usual exercise activities. Increase your activity level slowly. If the pain returns, stop exercising right away.

Know that shin splints can take 3 to 6 months to heal completely. Do not rush back into your sport or exercise. You could injure yourself again.

Reduce Your Pain and Swelling

Things you can do to ease discomfort include:

• Ice your shins. Ice several times a day for 3 days or until pain is gone.
• Do stretching exercises, especially over the front part of the shin.
• Take ibuprofen, naproxen, or aspirin to decrease swelling and to help with pain. Know these medicines have side effects and can cause ulcers and bleeding. Talk to your health care provider about how much you can take.
• Use arch supports. Talk with your provider or physical therapist about wearing the proper shoes, and about special shock-absorbing insoles or orthotics to wear inside your shoes.
• Work with a physical therapist. They can use therapies that may help with the pain. They can teach you exercises to strengthen your leg muscles.

How to Prevent Shin Splints

To prevent shin splints from recurring:

• Be pain-free for at least 2 weeks before returning to your exercise routine.
• Do not overdo your exercise routine. Do not return to your previous level of intensity. Go slower, for a shorter time. Increase your training slowly.
• Warm up and stretch before and after exercise.
• Ice your shins after exercise to decrease swelling.
• Avoid hard surfaces.
• Wear proper shoes with good support and padding.
• Consider changing the surface that you train on.
• Cross train and add in low impact exercise, such as swimming or biking.

When to Call the Doctor

Shin splints are most often not serious. Call your provider if:

• You have pain after several weeks even with rest, icing, and pain relievers.
• You are not sure whether your pain is caused by shin splints.
• Swelling in your lower legs is getting worse.
• Your shin is red and feels hot to the touch.

Your provider may take an x-ray or perform other tests to make sure you do not have a stress fracture. You will also be checked to make sure you do not have another shin problem, such as tendonitis or compartment syndrome.

References

Davenport M, Franco VS. Knee and lower leg injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 48.

Kubinski A, Amendola A. Medial tibial stress syndrome (shin splints). In: Miller MD, Hart JA, MacKnight JM, eds. Essential Orthopedics. 2nd ed. Philadelphia, PA: Elsevier; 2020:chap 159.

Mugleston BJ, Krabak BJ. Caring for and counseling the youth runner. In: Harrast MA, ed. Clinical Care of the Runner. Philadelphia, PA: Elsevier; 2020:chap 21.

Stretanski MF. Shin splints. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 78.

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