Lower Leg Pain: Don’t Let Shin Splints Derail your Training or Fitness Regimen

runner with shin splints

If you’ve ever experienced shin splints you know how irritating they can be. For those who have never experienced this, it’s an annoying, nagging pain or tenderness on the inside of the lower leg and sometimes they can derail an athletes’ training if not addressed. In this blog, we dive a little deeper into what shin splints are, what causes them, and how we can treat them.

What are Shin Splints?

Shin splints is a general term for pain on the front/inside or middle portions of the lower leg and can also be known as medial tibial stress syndrome (MTSS). The actual cause of MTSS is often debated among health care professionals but typically occurs when the large bone in the front of the leg is being stressed. Muscles and tendons attaching to that bone can experience microtearing or the muscle and periosteum tissue that wraps around the tibia can become inflamed further irritating the bone. As you might be able to guess, this stress is typically brought on my overuse or repetitive activity, especially in runners or athletes who have increased their mileage or training too quickly. In fact, exercise-related shin pain is experienced by up to 82% of runners over a single running season.1

What causes Shin Splints?

As mentioned previously, one of the most common causes of shin splints is stress brought on my overuse or overtraining but can also include inadequate footwear, changes in running surfaces, a lack of strength training and stretching, and inefficient running mechanics. If you are experiencing shin pain, it is important to decrease activity and seek treatment by a medical professional as these injuries can progress to stress fractures which can sideline an athlete for several weeks.

How do we treat Shin Splints?

Generally, treatment of shin splints is conservative and often includes formal physical therapy. The primary focus during physical therapy will include strengthening of multiple muscles of the lower leg, balance and proprioceptive training, and modifying the athletes training program to include a gradual increase in activity dependent on the athlete and their sport. An athlete might also benefit from a video gait analysis from a physical therapist as running mechanics can often be the cause of shin pain, and eventually stress fractures, if not corrected.

Other options to consider if you are sidelined with MTSS includes cross-training such as swimming and biking and ensuring you have the proper running shoes for your foot shape. Therapeutic taping of the shin can also provide some relief in symptoms. It is also extremely important to ensure an athletes training program is gradual. A physical therapist can help to revise a training program based on both injury prevention and the goals of the athlete or runner.

If you are experiencing shin pain that lasts more than a couple days or frequently experience symptoms, we advise you to see your orthopedic physician or primary care physician and discuss the potential for physical therapy and a video gait analysis. You can also head to our Instagram page to check out some exercises to perform for MTSS, schedule a complimentary screening with any of our Axes locations, or ask us about our video gait analysis to evaluate running mechanics.

(1) Reinking MF, Austin TM & Hayes AM (2010). Risk factors for self-reported exercise-related leg pain in high school cross-country athletes. Journal of Athletic Training. 45(1), 51-57.

About the Author: Sam Bixby, PT, DPT, Astym Cert, is a physical therapist at the Axes clinic in St. Charles. Having completed multiple marathons and other long-distance races herself, she enjoys working with an active patient population.

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