Shin Splints - Self-care

Alternative Names

Lower leg pain - self-care; Pain - shins - self-care; Anterior tibial pain - self-care; Medial tibial stress syndrome - self-care; MTSS - self-care; Exercise-induced leg pain - self-care; Tibial periostitis - self-care; Posterior tibial shin splints - self-care

What Are Shin Splints?

Shin splints occurs 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 exercise problem. You get shin splints from overloading your leg muscles, tendons or shin bone.

Shin splints happen from overuse with too much activity or an increase in training. Most often, the activity is high impact and repetitive exercise of your lower legs. This is why runners, dancers, and gymnasts often get shin splints. Common activities that cause shin splints are:

Running, especially on hills. If you are a new runner, you are at greater risk for shin splints.
Upping your number of days of training
Increasing the amount of time in 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 a 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.

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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 or biking.

After 2 to 4 weeks, if the pain is gone, you can start your usual 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. 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.
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 doctor about how much you can take.
Use arch supports. Talk with your doctor and 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.

Prevent Shin Splints When Exercise Again

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.
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 health care provider if:

You have pain even with rest, icing, and pain relievers after several weeks.
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

Carr K, Sevetson E, Aukerman D. Clinical inquiries. How can you help athletes prevent and treat shin splints? J Fam Pract. 2008;57:406-408. PMID: 18544325 www.ncbi.nlm.nih.gov/pubmed/18544325.

Marcussen B, Hogrefe C, Amendola A. Leg pain and exertional compartment syndromes In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 112.