Getting to the bottom of shin splints.

Perhaps you’ve experienced it yourself, a dull aching pain in the front of the lower leg when running or exercising. The pain may come on during activity and go away only to come on again after you’re done. It can become so intense that you may have had to stop what you were doing to get relief. Commonly known as shin splints, this inflammatory condition of the front part of the tibia is medial tibial stress syndrome (MTSS). The good news is, MTSS is relatively simple to treat.
 
The pain of a shin splint is brought on by strenuous activity and/or overuse. An athlete may experience it after making a change to their workout regime like increasing intensity or moving from a soft to a hard running surface. Shin splints are more common in sports that require quick accelerations and stops like squash, tennis or basketball, but are also frequently seen in runners and dancers.
 
The causes of shin splints
Shin splints occur during physical activity and result from too much force being placed on your shinbone and connective tissues that attach your muscles to the bone. Shin splints have two main causes, exerting excessive pressure on the lower leg muscles and excessive impact on the muscle.
 
Some activities that may lead to shin splints:
  • Running downhill
  • Running on slanted surfaces or uneven terrain
  • Running with inappropriate or worn out shoes, particularly for individual with flat feet or rigid arches
  • Taking part in sports with sudden stop and go motions
  • A sudden increase in activity or intensity or activity
  • Females with low bone density are at higher risk of developing shin splints and subsequent stress fractures
 
Diagnosing shin splints
A doctor can usually determine if a patient has shin splints with a physical exam and survey of activities. In some cases a physician may want to take x-rays to rule out a stress fracture.
 
Treating shin splints
Treating shin splints is pretty straightforward:
  • Rest
  • Ice
  • Elevation
 
A doctor will likely recommend two weeks' rest without running or impact sport. Cycling, swimming or walking are generally OK. Raising the leg and applying an ice pack 20-30 min every three to four hours to the affected area can help reduce the swelling and discomfort. To alleviate pain, your doctor may advise an over-the-counter anti-inflammatory painkiller (NSAIDs) like ibuprofen, naproxen, or aspirin.
 
Other treatments may include
  • Arch supports for your shoes (particularly for those with flat feet)
  • Range of motion exercises
  • Neoprene sleeve to support and warm the leg
  • Physical therapy to strengthen the muscles in your shins
 
Surgery is only warranted in cases where the pain is associated with severe stress fractures.
 
How long do shin splints last?
Generally speaking, athletes are eager to get back out there as soon as possible. However, it is not a good idea to rush back into your sport. If you start exercising before your shin splints have healed, you may hurt yourself permanently.
 
There is no definitive timeline for shin splints to heal, but pain is a good indicator. When you are pain and swelling free, you can resume activity, but you should start slowly and gradually build up speed and intensity.
 
Avoiding shin splints
Even if you are in love with an activity that isn’t great for your shins, there are things you can do to protect against this injury.
 
  • Use proper fitting shoes with good support
  • Make sure the insoles are shock-absorbing - if you have flat feet, good insoles are vital
  • Avoid hard surfaces, uneven terrain, or slanted slopes
  • Increase your intensity gradually
  • Make sure you warmed up properly before doing exercise
  • Stop working out as soon as you feel pain in your shins