What are shin splints and how do I manage them?

Shin splints is a common complaint, especially among participants of running sports. The term ‘shin splints’ is colloquially used to describe shin pain along the inside or front edges of the shin. Shin splints are the most common cause of painful shins.

Anterior Shin Splints
Anterior shin splints are located on the front (or anterior) part of the shin bone and involve the tibialis anterior muscle. The tibialis anterior lifts and lowers your foot. It lifts your foot during the swing phase of a stride. Then, it slowly lowers your foot to prepare your foot for the support phase.
If your anterior shin pain increases when lifting your toes up while keeping heels on the ground – you are likely to suffer from anterior shin splints. Medically anterior shin splints can also be referred to as anterior tibial stress syndrome (ATSS).

Posterior Shin Splints
Posterior shin splints are located on the inside rear (or medial/posterior) part of the shin bone and involve the tibialis posterior muscle. The tibialis posterior lifts and controls the medial aspect of your foot arch during the weight bearing support phase. When your tibialis posterior is weak or lacks endurance your arch collapses (overpronation), which creates torsional shin bone stresses.

If you feel pain along the inside rear of your shin bone – you are likely to suffer from either posterior shin splints or tibia stress fractures. Medically, posterior shin splints and tibial stress fractures can also be referred to as medial tibial stress syndrome (MTSS).

What Causes Shin Splints?

Shin splints are caused by overstraining of your muscles where they attach to your shin.
The most common cause is overuse or overtraining associated with poor foot and leg biomechanics. Shin splints can be caused by a number of factors which are mainly biomechanical (abnormal movement patterns) and errors in training.

Here are some of the most common causes:

Overpronation of your feet
Oversupination of your feet
Inappropriate footwear
Increasing your training too quickly
Running on hard or angled surfaces
Decreased flexibility at your ankle joint
Poor knee joint alignment
Poor buttock control at in the stance phase
Poor core stability
Tight calf muscles, hamstrings
Weak quadriceps, foot arch muscles

What are the symptoms of Shin Splints?

Shin splints cause dull, aching pain in the front of the lower leg.
Depending on the exact cause, the pain may be located along either side of the shinbone or in the muscles.
The area may be painful and warm to the touch.

How are shin splints diagnosed?

Shin splints are usually diagnosed based on your medical history and a physical examination by your physiotherapist. In some cases, an X-ray or other imaging studies such as bone scans or MRI can help identify other possible causes for your pain, such as a stress fracture.

Treatment for Shin Splints

Phase 1 – Early Injury Protection: Pain Reduction & Anti-inflammatory Phase

As with most soft tissue injuries the initial treatment is – Rest, Ice and Protection.
In the early phase you may be unable to walk or run without pain, so your shin muscles and bones need some active rest from weight-bearing loads. Your physiotherapist will advise you on what they feel is best for you.
Ice is a simple and effective modality to reduce your pain and swelling. Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot.
Anti-inflammatory medication (if tolerated) and natural substances eg arnica may help reduce your pain and swelling. Most people can tolerate paracetamol as a pain reducing medication.
As you improve a kinesio style supportive taping will help to support the injured soft tissue and provide some stress reduction for your shin bone.

Phase 2: Regain Full Range of Motion

If you protect your injured shin muscles while they heal and strengthen. This may take several weeks.
During this time period you should be aiming to remold your scar tissue to prevent a poorly formed scar that will re-tear in the future.
It is important to lengthen and orientate your healing scar tissue via massage, muscle stretches, neurodynamic mobilisations and specific exercises.
Your physiotherapist will guide you.

Phase 3: Normalise Foot Biomechanics

Shin splints commonly occur from poor foot biomechanics eg flat foot.
In order to prevent a recurrence, your foot will be assessed. In some instances, you may require a foot orthotic (shoe insert) or you may be a candidate for the Active Foot Posture Stabilisation program.
Your physiotherapist will happily discuss the pros and cons of both options to you.

Phase 4: Restore Muscle Strength

Your calf and shin muscles will need to be strengthened to enable a safe resumption of sport or training.

Phase 5: Modified Training Program & Return to Sport

Most shin splints occur due to excessive training loads. Running sports place enormous forces on your body (contractile and non-contractile).
In order to prevent a recurrence as you return to sport, your physiotherapist will guide you with training schedules and exercises to address these important components of rehabilitation to both prevent a recurrence and improve your sporting performance.
Depending on the demands of your chosen sport, you will require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to your chosen sport.

Your PCA physiotherapist will discuss your goals, time frames and training schedules with you to optimise you for a complete return to sport.

The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a thorough rehabilitation program has minimised your chance of future injury.

Call 0813 028 0496 for more information!