Shin splints, also known as medial tibial stress syndrome (MTSS), is a term used to describe symptoms of pain in the front of your lower leg and at times along the inside of the lower leg, next to the shin bone (tibia). It occurs when too much stress is put on the tibia or when the muscle next to the tibia is overworked. It most commonly happens from high-energy exercise or sports that involve running and jumping, and at the beginning of a sports or training program.
Thankfully, shin splints can often be treated effectively, and, with proper progression of exercise program, prevented if seen before beginning an exercise program. Here are some simple steps that you can take on your own:
Stretch your calves and hamstrings. Tight muscles in the leg can put you at risk for shin splints.
Avoid sudden increases in physical activity. Gradually increase activities such as running, jumping, and walking. This includes spreading out days between activities and/or doing alternate forms of exercise.
Exercise on softer surfaces when possible. Exercising on hard surfaces, such as concrete (eg, sidewalks), increases the amount of force that your bones and muscles have to absorb. This causes muscle fatigue and overuse, and ultimately, shin splints.
Choosing more “pliant” or soft surfaces (eg, sprung wood floors, grass, dirt, sand, synthetic tracks and fields) will prevent your bones, muscles, tendons, and joints from having to absorb so much shock.
Strengthen your foot and the arch of your foot. The arch of your foot forms by the time you are 7 to 8 years old. Injury, age, and other health conditions can alter the structure of the arch; lack of physical activity will create weakness in the muscles of the foot, lower leg, thigh, and trunk. These changes can affect your lower leg and lead to shin splints.
Strengthening your foot can be a good place to start. For example, using your toes to pull a towel on the floor closer to your foot while sitting can help strengthen the arch muscles. This may help the arch work more effectively to reduce or prevent shin splint pain. A physical therapist can teach you the best exercises for your feet. Foot orthotics (ie, arch supports) can be used to assist your foot to work better. If your arch is low orthotics can give support to them. Less frequently, high arches can be an issue and foot orthotics can allow more shock absorption, which will decrease stress.
Strengthen your hip muscles. Strengthening your hip muscles helps absorb more of the shock and pressure on the leg during exercise. See your physical therapist to learn the correct exercises for your needs.
Buy new athletic shoes that are right for you. Ill-fitting shoes or shoes that lack proper features can contribute to shin splints. Speak with your physical therapist about the right shoe features for you. Depending on your activity, you may need to replace shoes often. It’s a great idea to have several pairs of good athletic shoes, and regularly rotate the pair you use.
Stay at a healthy body weight. Increased body weight, being overweight, or obesity can lead to a higher risk of shin splints.
Have your running and jumping technique analyzed and corrected by a physical therapist. Incorrect running, jumping, and landing techniques can cause shin splints. Your physical therapist can help you understand how to improve your exercise technique to avoid shin splint pain. Your physical therapist also can check to see which muscles are tight or weak, and teach you how to stretch and strengthen them.
Physical therapists can observe how a person moves, determine how their body reacts, and then establish a program of care for prevention, recovery, and progression of desired activity.
Blog provided courtesy of the APTA #choosePT, Authored by Andrea Avruskin PT, DPT.
Zimmermann WO, Helmhout PH, Beutler A. Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces. J R Army Med Corps. 2017;163(2):94–103. Free Article. https://jramc.bmj.com/content/163/2/94.long
Sobhani V, Shakibaee A, Khatibi Aghda A, Emami Meybodi MK, Delavari A, Jahandideh D. Studying the relation between medial tibial stress syndrome and anatomic and anthropometric characteristics of military male personnel. Asian J Sports Med. 2015;6(2):e23811. Free Article. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592759/
Yagi S, Muneta T, Sekiya I. Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):556–563. Article Summary in PubMed. https://www.ncbi.nlm.nih.gov/pubmed?term=%22Knee+surgery%2C+sports+traumatology%2C+arthroscopy+%3A+official+journal+of+the+ESSKA%22%5BJour%5D+AND+556%5Bpage%5D+AND+2013%5Bpdat%5D&cmd=detailssearch