Shin splints are a common overuse injury causing lower leg pain, but the name often causes concern about a broken bone. Shin splints do not represent a broken leg; the condition involves inflammation of the soft tissues surrounding the shin bone, not a fracture. Ignoring the pain can lead to a more serious injury. If left unaddressed, the repetitive stress can weaken the bone and potentially progress into a small crack in the bone structure.
What Shin Splints Really Are
The clinical term for shin splints is Medial Tibial Stress Syndrome (MTSS), which refers to pain along the inner edge of the tibia, or shin bone. MTSS is an inflammation of the muscles, tendons, and connective tissue that attach to the outer layer of the tibia, known as the periosteum. The muscles most commonly involved are the posterior tibialis, flexor digitorum, and soleus, which help stabilize the lower leg during movement.
Repetitive, high-impact activities like running or jumping place excessive traction force on these muscle attachments. This condition is considered an overuse injury, resulting from the bone being overloaded without sufficient time to adapt. Common causes include a sudden increase in the intensity, frequency, or duration of physical activity. Biomechanical factors also play a role, such as wearing worn-out or improper footwear, having flat feet, or running on hard surfaces.
Recognizing the Difference Between Shin Splints and a Stress Fracture
The primary concern when experiencing shin pain is distinguishing MTSS from a tibial stress fracture, which is a true break in the bone requiring a much longer recovery. The difference lies in the pain’s location, intensity, and timing. Pinpoint tenderness is a key differentiator, as a stress fracture causes sharp, localized pain in one specific spot on the bone. In contrast, MTSS pain is generally more diffuse, spread out along a few inches of the inner border of the shin bone.
The pattern of pain during activity is also revealing. Shin splint pain often begins early in a workout, may lessen as the body warms up, and then returns after exercise is complete. Stress fracture pain usually worsens continuously during activity and persists even when resting, sometimes waking a person from sleep.
Tenderness upon touch and the presence of swelling are further distinguishing features. With MTSS, tenderness is spread out and tolerable. A stress fracture often presents with a noticeable, tender lump or localized swelling, and pressing directly on the site causes a sharp, intense increase in pain. If the pain prevents a person from hopping even a few times on the affected leg, a stress fracture is highly probable.
Treatment and Preventing Future Injuries
The initial management for shin splints centers on reducing inflammation and stress on the injured tissues. Immediate care should follow the R.I.C.E. protocol:
- Rest from high-impact activity.
- Ice the affected area for 15–20 minutes several times a day.
- Use Compression to reduce swelling.
- Elevation of the leg.
Low-impact activities, such as swimming or cycling, can be used for cross-training to maintain fitness while the tissues heal.
Long-term prevention focuses on correcting training errors and biomechanical issues that caused the overuse injury. A primary rule is to adhere to the “10% rule,” which advises against increasing the total weekly training load by more than ten percent. This gradual progression allows the body’s musculoskeletal system adequate time to adapt to the increasing stress. Selecting supportive footwear appropriate for one’s foot type and replacing running shoes every 300 to 500 miles is also important for shock absorption.
Strengthening the muscles of the lower leg, specifically the calf muscles and the anterior tibialis, helps to improve shock absorption and stability. Stretching tight muscles, such as the calves, is also beneficial, as restricted flexibility can place undue strain on the shin. If pain does not subside after a few weeks of rest, or if symptoms include pain that persists at rest, significant swelling, or an inability to bear weight, consult a medical professional to rule out a tibial stress fracture.