Shin Splint Syndrome

November 12, 2020

Shin splints, also known as medial tibial stress syndrome (MTSS).

Shin Splint Syndrome

Shin Split, is a term used to describe pain in the front of your lower leg and at times along the inside of the lower leg, next to the shin bone (tibia). 

Shin splints are a cumulative stress disorder. Repeated pounding and stress on the bones, muscle, and joints of the lower legs causes pain & discomfort.

Shin splints frequently affect people who engage in moderate to heavy physical activities that involve running and jumping or stop-start sports such as tennis, racquetball, soccer, or basketball.

Causes –

The pain associated with shin splints results from excessive amounts of force on the shin-bone and the tissues attaching the shin bone to the muscles surrounding it.

The excessive force causes the muscles to swell and increases the pressure against the bone, leading to pain and inflamation.

  • Repetitive running on hard surfaces or forcible, excessive use of the foot flexors

  • Lack of flexibility

  • Flat foot syndrome or high arches

  • Improper training techniques

  • Running on uneven terrains, such as hills, or hard surfaces, such as concrete

  • Using inappropriate or worn-out shoes for running or workouts

  • Participating in sports that have fast stops and starts (like soccer or downhill skiing)

  • Working out without warm-up or cool-down stretches

  • Weak ankles, hips, or core muscles

  • Suddenly increasing the duration, frequency, or intensity of exercise

  • Post stress fracture

Symptoms –

People with shin splints will experience some of the following symptoms:

  • A dull ache in the front part of the lower leg

  • Pain that develops during exercise

  • Pain on either side of the shin bone

  • Pain along the inner part of the lower leg

  • Tenderness or soreness along the inner part of the lower leg

  • Swelling in the lower leg (usually mild, if present)

Here are some simple steps that you can take on your own:

Change of training conditions could be decreased by running distance, intensity, and frequency, and intensity by 50%. It is advised to avoid hills and uneven surfaces.

During the rehabilitation period, the patient can do low impact and cross-training exercises (like running on a hydro-gym machine).). After a few weeks, athletes may slowly increase training intensity and duration and add sport-specific activities

Developing core stability with strong abdominal, gluteal, and hip muscles can improve running mechanics and prevent lower-extremity overuse injuries.

Proprioceptive balance training is crucial in neuromuscular education. This can be done with a one-legged stand or balance board. Improved proprioception will increase the efficiency of joint and postural-stabilizing muscles and help the body react to running surface incongruities, also key in preventing re-injury.

1. Stretch your calves and hamstrings.

Tight muscles in the leg can put you at risk for shin splints.

2. Avoid sudden increases in physical activity.

Gradually increase activities such as running, jumping, and walking. This includes spreading out days between activities and/or doing alternate forms of exercise.

3. Exercise on softer surfaces when possible.

  • Exercising on hard surfaces, such as concrete (eg, sidewalks), increases the amount of force that your bones and muscles have to absorb. This causes muscle fatigue and overuse, and ultimately, shin splints.

  • Choosing more “pliant” or soft surfaces (eg, sprung wood floors, grass, dirt, sand, synthetic tracks, and fields) will prevent your bones, muscles, tendons, and joints from having to absorb so much shock.

4. Strengthen your foot and the arch of your foot.

  • The arch of your foot forms by the time you are 7 to 8 years old. Injury, age, and other health conditions can alter the structure of the arch; lack of physical activity will create weakness in the muscles of the foot, lower leg, thigh, and trunk. These changes can affect your lower leg and lead to shin splints.

  • Strengthening your foot can be a good place to start. For example, using your toes to pull a towel on the floor closer to your foot while sitting can help strengthen the arch muscles. This may help the arch work more effectively to reduce or prevent shin splint pain. A physical therapist can teach you the best exercises for your feet.

  • Foot orthotics (ie, arch supports) can be used to assist your foot to work better. If your arch is low orthotics can give support to them. Less frequently, high arches can be an issue and foot orthotics can allow more shock absorption, which will decrease stress.

5. Strengthen your hip muscles.

Strengthening your hip muscles helps absorb more of the shock and pressure on the leg during exercise. See your physical therapist learn the correct exercises for your needs.

6. Buy new athletic shoes that are right for you.

Ill-fitting shoes or shoes that lack proper features can contribute to shin splints. Speak with your physical therapist about the right shoe features for you. Depending on your activity, you may need to replace shoes often. It’s a great idea to have several pairs of good athletic shoes, and regularly rotate the pair you use.

7. Stay at healthy body weight.

Increased body weight, being overweight, or obesity can lead to a higher risk of shin splints.

8. Have your running and jumping technique analyzed and corrected by a physical therapist.

  • Incorrect running, jumping, and landing techniques can cause shin splints. Your physical therapist can help you understand how to improve your exercise technique to avoid shin splint pain. Your physical therapist also can check to see which muscles are tight or weak, and teach you how to stretch and strengthen them.

  • Physical therapists can observe how a person moves, determine how their body reacts, and then establish a program of care for prevention, recovery, and progression of desired activity.

Ice your shin to ease pain and swelling. Do it for 20-30 minutes every 3 to 4 hours for 2 to 3 days, or until the pain is gone.

Use insoles or orthotics for your shoes. Shoe inserts -- which can be custom-made or bought off the shelf -- may help if your arches collapse or flatten when you stand up.

  • Avoid overdoing. Too much running or other high-impact activity performed for too long at too high an intensity can overload the shins.

  • Consider shock-absorbing insoles. They might reduce shin splint symptoms and prevent a recurrence.

  • Consider arch supports. Arch supports can help prevent the pain of shin splints, especially if you have flat arches.

  • Lessen the impact. Cross-train with a sport that places less impact on your shins, such as swimming, walking, or biking. Remember to start new activities slowly. Increase time and intensity gradually.

  • Add strength training to your workout. Exercises to strengthen and stabilize your legs, ankles, hips, and core can help prepare your legs to deal with high-impact sports.


Written by, Pooja Physiotherapy & Healthcare Centre 

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