Shin Splints & Shin Pain

“Shin Splints” is a common but non-specific term for pain in the shin region. Shin pain can be due to several different conditions, most commonly medial tibial stress syndrome, (but can also be due to stress fractures, compartment syndrome, tibialis posterior tendinopathy, nerve entrapment and several other conditions).

Signs & Symptoms

Medial tibial stress syndrome is the inflammation of the muscles and deep tissues along, and to the side of, the shin bone.  The area is usually tender and swollen to touch, aches during and after exercise, and is painful whilst walking, running, skipping and jumping.

Common Causes of Shin Pain:    

• Road running or sprinting on hard ground
• Or conversely, very soft surfaces (eg. sand)
• Excess or rapid pronation (flattening of feet)
• Inappropriate footwear
• Running technique and biomechanical factors
• Weak or tight calves
• Over training, or sudden increase in training/running distance
• Prolonged running uphill (eg. Point to Pinnacle!) or backwards (eg. umpires, linesmen)
• Poor kicking technique (football, soccer)

Physiotherapy Treatment Includes

• RICE (Rest, Ice & Elevate) in the early stages, especially if pain persists >1hr after exercise
• Massage to loosen tight calves
• Taping to support foot, ankle or both
• Advice about footwear, especially running or sporting shoes (please bring these along to your appointment)
• Orthotics if required, especially if shin pain is felt with walking (either prefabricated or referral to a podiatrist)
• Exercises to stretch tight calves and strengthen weak calves
• Biomechanical assessment of running technique (eg. FLEX Running Screening), and exercises to address contributing factors
• Running drills, especially relevant to landing and push off
• Advice about timeframes, encouraging non or low impact exercise as cross training for fitness during recovery (eg. swimming, cycling, low impact gym work, pilates)
• Guiding graduated return to running and running based sports
• Discussing training principles (eg. periodisation, cross training, training schedules, terrain, footwear etc.) where relevant

Early Intervention is the Key

Seeking advice early will lessen the length of time before return to sport is safe, and prevent further complications.  If medial tibial stress syndrome remains untreated, it may lead directly to stress fractures of the shin bone.  It is also important to rule out more serious problems, such as compartment syndrome, where specialised testing, and sometimes surgical release along the shin bone may be required in severe cases.