Updated: Jul 5, 2021
‘Shin Splints’ is not actually a specific diagnosis but has become an umbrella term encompassing a range of lower leg related conditions.
If you are new to running or have recently increased your mileage you might find that you have some mild, intermittent shin pain that you only get when running or immediately after. This is pretty common and can often be managed very simply with some rest, stretching and foam rolling of your calf muscles. If this doesn’t work or your pain is severe you should seek professional advice.
Although there are many causes of shin pain, bony pain is normally what people are referring to when discussing shin splints. Bony pain is a result of a bony stress reaction and there is a genuine risk of stress fracture - hence why assessment is so important. Bony pain is a result of overloading the bone with the repetitive impacts during running. Although impact is good for strengthening bones, if load is excessive and there is inadequate time for recovery and new bone formation, then a stress response can occur resulting in pain.
This pain mostly occurs in the lower two thirds of the inside of your shin bone and is known as medial tibial stress syndrome (MTSS). Pain is provoked by physical activity, particularly running and eases within 48 hours of relative rest. This area has a good blood supply and can usually recover well enough to begin to return to running within 4-8 weeks. It is important to do this with the support of a therapist as MTSS may progress to a stress fracture although this is not always the case. If your symptoms are on the front of your shin bone this is more complex and it is especially important you seek professional advice.
Unfortunately you are likely to need a rest period from running however you can complete low impact activities such as swimming and cycling. Your therapist will commence a strength and conditioning programme with you to help you recover and avoid a return of symptoms. As well as this they will work with you to gradually increase your running time, distance and intensity to prevent further overload of the bony structures.
It is also important to discuss with a professional the possible causes so that these can be addressed going forwards. Causes to consider include; training error, running shoes, biomechanics, running form and motor control and muscle tightness and weakness.
If you are struggling with shin pain, book a consultation on the website and we’d be happy to help you at LR Elite Sports Therapy.
Medial tibial stress syndrome can be diagnosed reliably using history and physical examination, M Winters, E W P Bakker, M H Moen, C C Barten, R Teeuwen, A Weir, British Journal of Sports Medicine, 2018, 52: 1267-1272
Medial Tibial Stress Syndrome: Diagnosis, Treatment and Outcome Assessment. 2017, Marinus Winters
A review article of medial tibial stress syndrome. S M Alfayez, M L Ahmed, A Z Alomar, 2017, Journal of Musculoskeletal Surgery and Research, 1:2-5
Shin pain, shin splints and Stress Fractures, Tom Goom, running-physio.com, May 2012.