How to Prevent and Treat Shin Splints

Are you one of many people whose shins ache when you exercise? Then you may suffer from shin splints. 

“If you’re an athlete or active individual, you likely know someone who has dealt with the pain from this injury or have experienced it yourself,” says Jon Mousette, ATC, a Mass General Brigham athletic trainer.

Mousette explains what exactly shin splints are, their causes, and how you can treat them — or prevent them — in the future.

What are shin splints?

The proper medical term for shin splints is medial tibial stress syndrome. It’s an inflammation of the muscles, tendons, and bone tissue around your tibia. 

Shin splints became a more common term for the condition, describing the targeted pain on the inside of your tibia, or “shin bone.” Pain generally starts as a strained soreness. If left untreated, the pain can intensify and leave you physically unable to continue with your sport or preferred activity. 

The symptoms of shin splints can be different for everyone, ranging from a dull ache to a sharp, stabbing pain. Most times, you will be able to pinpoint a tender portion on the inside of your lower shin.

Risk factors for shin splints

Some risk factors for shin splints include:

• A sudden increase in the level of intensity of your workout or sport
  
• Overtraining
• Running, such as cross country running, both as a beginner or as a seasoned runner
• Running on hard, flat surfaces, such as concrete or asphalt
• Having flat feet or high arches
• Military training

Preventing shin splints

Prevention is a significant component to keeping your shins in proper working condition. Completing a good warmup before working out can help ease your muscles into physical activity. Overall, stretching and foam rolling will also help your muscles stay healthy.

If prevention is not enough, simple measures can help ease the discomfort of shin splints before the pain spirals out of control. Proper footwear is a large component for preventing injury. 

“Replace your shoes as they wear down, similar to how you would replace the tires on your car,” says Mousette. “More miles mean you may need to replace them sooner. Also, ensure you are wearing the correct footwear. Feet are not one size fits all, and it may be beneficial to be fitted by a professional to ensure the best fit and level of support that you require.”

Other prevention tips include:

• Add weight training to your schedule. This training will strengthen other areas of your body and allow you to protect yourself from injury. Remember, strength takes time. Focusing on your muscles and allowing your body to get stronger may help to prevent future injury. 
• Increase your level of activity gradually as your body allows. If you are used to running 2 miles at a time, your body is not ready to run a marathon the next day. Overloading your body can take a toll on your shins. If your shins are starting to feel sore and tired, allow them to rest. 
• Switch up your activity temporarily. This allows you to get stronger, but can decrease the load on your tired shins. Biking, swimming, and use of the elliptical can be great ways to cross train and allow your body to heal. 
• RICE (Rest, Ice, Compression, and Elevation). Resting, icing, using compression, and elevating your legs can help you manage shin splints and prevent ongoing pain.  

Treating shin splints

• Cryotherapy. The use of ice, also known as cryotherapy, can be beneficial in the reduction of the pain associated with shin splints. When icing, be sure to use the 20/20 rule — this means icing the area for 20 minutes, then removing the ice and waiting for at least 20 minutes before icing again. By doing this, your leg can warm up, blood supply recirculates, and effective healing increases. Additionally, adding range of motion exercises in the periods between icing will allow your muscles to work better.  
• Elevate your legs above the level of your heart. While your leg is elevated, use your toes to make circles in the air, working your way from small to large circles. You may also “trace” the letters of the alphabet or spell your name in the air. The gravity allows for any swelling in your leg to decrease and move out of the area. A decrease in swelling can also help to decrease the pain.
• NSAID. The use of NSAID (nonsteroidal anti-inflammatory drug) medications, such as Ibuprofen or Advil, will also help decrease the overall pain and swelling. Follow the directions on the back of the medication bottle and take the medications every few hours as directed. This may help improve your symptoms and allow you to eventually ease back into activities. Check with your doctor to ensure you have no other conditions that would prevent you from taking these medications. 

These treatments are great to try at home, but if symptoms persist, it may be time to find outside help. 

When is it time to get medical care for shin splints?

If you’ve tried treating your shin splints at home without any improvement, it may be a good time to reach out to your health care team. 

For youth or collegiate athletes, a school athletic trainer is a great resource to start with, helping to review your signs and symptoms and weighing treatment options. They may recommend you connect with your primary care provider (PCP) or orthopedic provider or even recommend physical therapy. They may recommend orthotic inserts, and perform a detailed analysis of your walking or running pattern to provide guidance.

“Your treatment team will help you rule out more serious injury, like a stress fracture or other medical conditions,” says Mousette. “Ultimately, they’re all there to assist you and help get you back in the game.”