Shin Splints

What are shin splints?

The term shin splints is a common misnomer in sports medicine. It does not imply a specific diagnosis, rather it is the symptom of pain over the front of the tibia bone. The pain from shin splints can be due to either problems of the muscles, the bone, or the attachment of the muscle to the bone. Therefore, 'shin splints' is simply the name given to pain over the front of the lower leg.

Symptoms

Common symptoms of shin splints include tenderness, aching or slight swelling along the front of your lower leg.

The pain is often worse when you do activities that involve supporting your body weight. You may feel pain along the length of your shin, or only along a small section.

Causes

Shin splints occur when you put too much stress and strain on your shin bone. This happens when there is repetitive impact on your shin bone during weight-bearing sports or activities.

You are more at risk of developing shin splints if:

• you rapidly increase your training levels (for example your running distance, speed or number of times you run in a week)
• your sport or activity involves running or jumping on a hard surface (such as dancing or aerobics)
• your shoes are worn down and have lost their cushioning and support
• your feet roll inwards (pronate)
• you have weakness in the muscles that attach onto the bone

Diagnosis

You may wish to go and see your GP or a chartered physiotherapist if you have shin pain. He or she will ask about your symptoms, examine you and may ask about your medical history. There is usually a clear link between shin pain and a sport or activity.

Your doctor or physiotherapist may recommend that you have a scan or X-ray to look at your shin in closer detail. These tests are often done to rule out other conditions which may affect your shins such as large stress fractures. Your doctor or physiotherapist may request one of the following tests.

• An X-ray. Pictures of your shin bone are created using X-rays.
• An MRI (magnetic resonance imaging) scan. Pictures of your shin bone are created using magnets and radio waves.
• A bone scan. This is similar to having an X-ray but uses gamma rays instead. You will be given a small amount of a radioactive chemical, usually by injection before having this scan.

Treatment

For most people, shin splints can be successfully treated by the following self-help measures.

• Apply a cold compress, such as ice or a bag of frozen peas, wrapped in a towel, to help reduce swelling and bruising. You shouldn't apply ice directly to your skin as it can damage your skin.
• Over-the-counter anti-inflammatory medicine such as ibuprofen can help reduce pain and inflammation. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.
• Rest is vital for treating shin splints. While you are recovering, don't do activities that cause pain. You can resume training gradually once your shins are no longer painful.
• Ensure that your trainers give enough support and cushioning and haven't become worn down through wear.

• A physiotherapist can provide a range of treatments and advice to help relieve pain and promote healing. He or she can help devise a graduated training programme to promote recovery and help you return to your usual sports activities.
• A podiatrist (a health professional who specialises in treatment of the feet) can provide advice about foot care and supply shoe inserts to stop your feet from rolling inwards.

You can keep fit during your recover by doing activities that don't put too much strain on your shins, such as swimming and cycling.

Prevention

The following steps can help reduce your risk of developing shin splints.

• Wear footwear that is appropriate for your sport or activity and make sure that they provide enough support and cushioning.
• Wear shoe inserts if your doctor or podiatrist advises you to.
• Follow the correct technique for your sport.
• Don't suddenly change your training regime.
• Eat a diet rich in vitamins and minerals, and make sure you eat enough calcium-rich foods such as dairy products.

These are important for keeping your bones strong and healthy.

Further information