“Shin splints” is one of the most diagnosed injuries among recreational runners. Shin splints is a periostitis (“itis” = inflammation of) of the lower 2/3 of the leg. When the pain is along the inner edge of the leg, it is often termed Medial Tibial Stress Syndrome. The periosteum is a connective tissue membrane that lines the bone and serves as an attachment site for muscles. Through overuse and poor mechanics, the muscle can potentially tear away from the periosteum, resulting in pain and inflammation. Historically, the tibialis posterior muscle has been thought to be the source of the pain, but more recent evidence implicates the soleus or flexor digitorum longus (see images) as the source. All of these muscles insert along the back/inner edge of the tibia, which is the location of pain. Pain can also present along the front, outer edge of the tibia. This is less common, and can be treated similarly to what is presented here for Medial Tibial Stress Syndrome.
Risk Factors Contributing to Shin Splints
Tibialis Posterior (Wikipedia)
Soleus (Wikipedia)
- Females more likely than males
- Pronated (flat) foot
- Poor running mechanics
- Poor flexibility – especially in the hamstrings and calves
- Improper/poor footwear
- Exercise intensity – too much too soon?
- High BMI (Body Mass Index)
Symptoms
- Dull ache along lower two thirds of leg (along inside edge of tibia)
- Sharp pain with activities and tender to the touch
- Possible swelling
Other Possible Injuries/Syndromes To Rule Out
- Stress Fracture – Pain is usually more localized to one spot and very sharp
- Exercise-induced compartment syndrome
- Popliteal artery entrapment
- Claudication
Shin Splints Treatment and Prevention
- Eliminate the stressor
- Rest
- Cross-train to maintain fitness (i.e. bike, swim, etc…)
- Control the inflammation
- Ice or ice massage
- Anti-inflammatory medication (check with physician prior)
- Address risk factors
- Foot biomechanics and strengthening
- Footwear
- Running mechanics
- Flexibility (see “Stretches”)
Stretches
Here are a set of stretches that should help you with shin splints. Make sure to hold each stretch for at least 30 seconds.
Hamstring Stretch
- Supine (on back)
In an open doorway, rest your heel on the door frame and adjust your body within the doorway so that the leg that you are stretching is straight. - Standing
Keeping hips level and facing straight ahead, prop your heel up on a bench or chair in front you, and lean forward towards your foot, keeping your spine straight.
Calf Stretches (“Calf” = 2 muscles à Gastrocnemius and Soleus)
- Gastrocnemius
This muscle crosses the knee, so the knee must be straight to get a good stretch. Stand against a wall in a lunge position and lean forward, keeping your back knee straight (this is the calf you are stretching). - Soleus
This muscle does not cross the knee, so to isolate it from the gastrocnemius, the knee must be slightly flexed. Everything else is the same. Stand against a wall in a lunge position and lean forward.
