Shin splints, medically known as Medial Tibial Stress Syndrome (MTSS), is a common overuse injury causing pain along the inner edge of the shinbone (tibia). This discomfort results from repetitive stress on the muscles and connective tissues, often affecting runners and athletes. Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive, drug-free method used to manage this localized pain. The device delivers low-voltage electrical impulses through electrode pads placed on the skin. Effective relief depends significantly on the precise positioning of these electrodes and using the correct settings.
The Basics of TENS for Pain Relief
TENS alleviates discomfort through two primary physiological mechanisms. The first is the Gate Control Theory, where electrical impulses stimulate sensory nerves faster than pain signals travel. This rapid stimulation “closes a gate” in the spinal cord, blocking pain messages from reaching the brain and reducing pain perception. The resulting tingling sensation provides a competing stimulus that distracts the nervous system.
The second mechanism involves the release of the body’s natural painkillers, endorphins. Endorphin release is typically triggered by lower-frequency TENS settings and reduces pain intensity. While TENS does not cure the underlying tissue damage causing shin splints, it offers temporary symptomatic relief. This temporary relief can increase comfort during rest or rehabilitation exercises.
Specific Electrode Placement Techniques
Correct electrode placement is the most important factor for maximizing TENS effectiveness. Since shin splints can cause pain along the inner shin (medial) or the front of the shin (anterior), placement must be tailored to the exact site of discomfort. The general rule is to position the pads so the electrical current flows across or surrounds the painful area, avoiding direct placement onto the bone.
For Medial Tibial Stress Syndrome, the most common presentation, pain is felt along the inner, rear edge of the tibia. A common approach uses a pair of electrodes, placing one pad just above the painful area and the second pad just below it, flanking the pain site. Alternatively, pads can be placed on either side of the pain to ensure the current passes horizontally through the affected soft tissue.
If pain is focused on the front of the leg, involving the tibialis anterior muscle, pads should be placed directly over the muscle belly. One electrode can be placed near the top of the muscle, just below the knee, and the second pad placed lower down, closer to the ankle. Electrodes must be applied to clean, dry skin to ensure proper conductivity and adhesion. Maintain a minimum distance of at least one pad’s width between the two electrodes to prevent short-circuiting and ensure deeper current penetration.
Recommended Treatment Settings and Safety
Optimal TENS settings provide a strong, comfortable sensation without causing muscle contraction or twitching. Users should begin with the lowest intensity and gradually increase it until a distinct, non-painful tingling is felt beneath the pads. If muscle twitching occurs, the intensity is too high and must be immediately reduced.
For acute pain relief, high-frequency settings (typically 80 to 120 Hertz) are recommended to activate the Gate Control mechanism. Treatment sessions should last between 20 to 30 minutes and can be repeated several times daily for ongoing pain management. TENS provides symptomatic relief but does not replace the need for rest, ice, and professional evaluation to address the root cause of shin splints.
Several safety precautions must be observed before using a TENS unit. The device should never be used if you have an implanted electronic device, such as a pacemaker, as the electrical currents can interfere with its function. Electrodes must never be placed over broken skin, infected tissue, or near the heart or head. Individuals who are pregnant or have a history of epilepsy should consult a healthcare provider before beginning TENS therapy.