Have your shins been painful during and after running lately? You may be dealing with medial tibial stress syndrome, more commonly known as shin splints. Let’s discuss what shin splints are, how they develop, and how you can get over them so you can get back to your favorite activities pain-free!
What are shin splints?
Medial tibial stress syndrome or shin splints can be defined as pain or discomfort along the edge of your tibia (the bone that runs down the front of your lower leg) that primarily occurs during exercise. Shin splints are especially common with activities that require repetitive loading such as running, jumping, or dancing. Shin splints are one of the most common painful syndromes among athletes and are the most frequent injury among runners1.
How do shin splints develop?
When you run or jump during athletic activity, your bones, joints, and muscles in your legs have to absorb the ground reactive force, which is the impact of your feet returning to the ground with each stride or jump. When the amount of impact that you’re absorbing during exercise OR the total amount of exercise is more than your legs can currently handle, you may begin to experience discomfort during the activity. One of the most common areas where this discomfort develops is in the shin bones and their surrounding muscles, because they help absorb a significant amount of the ground reactive force. Shin splints develop over time due to these excessive forces on your lower legs and can be classified as an overuse injury. This condition is one of the most common lower leg injuries among runners.
Overuse injuries commonly occur when someone begins a new activity or are returning to an activity after a long break. Oftentimes, overuse injuries can be described as “too much, too soon, at too high of an intensity.” “Too much, too soon” refers to the volume (how much exercise you’re performing) and frequency (how often you’re exercising) of exercise. For example, if you are a beginning runner, doing too much too soon would be going from running 1 mile on 3 days one week (3 miles total) to 3 miles on 5 days the next week (15 miles total). This would be a 500% increase in running volume and a 67% increase in running frequency. Your body is likely going to have a hard time adjusting to the sharp increase in the amount of stress that you are placing on your legs.
“Too high of an intensity” refers to how fast you’re running, how high or far you’re jumping, or how difficult your dance moves are. Let’s go back to the running example. You recently ran a mile at max effort in 9 minutes. An abrupt increase in intensity would look like transitioning from running 1 mile each session at 11 minutes per mile to running 3 miles per session at 10 minutes per mile. The faster you run, the more force that your muscles and bones have to absorb. It’s important to make small changes to your exercise routine over time to progressively overload your body so that your performance improves.
How can I determine whether I have shin splints or some other issue?
When dealing with lower leg pain, one of the most important aspects is determining the difference between shin splints and a bone stress injury. A bone stress injury or stress fracture is a serious running injury that can have long term effects on your ability to exercise if it is not dealt with properly. I’m going to outline a couple of self-tests that you can perform to help determine whether your pain is coming from shin splints or something more serious.
- Test 1: Find the bony border of your shin. Press on this bony border and on the area where your muscles and the bony border meets. Press along the whole length of your shins, starting at your knee and down to your ankle.
- Test 2: Take a look at your shins – are there any areas where the color of your skin has changed, any redness or swelling?
- Results of tests: For Test 1, if you had a painful area along your shin that was about 2 inches in length or more and this is the same area that hurts when you run, this indicates that you may have shin splints. However, if you pressed along your shin and had one very specific painful spot in the bone, this may indicate a bone stress injury. If you have this specific painful spot and noticed a skin color change and/or swelling, this may further indicate a bone stress injury.
What should I do for my injury?
If after reading this article, you suspect that you have either shin splints or a bone stress injury, you should get evaluated by our physical therapists as soon as possible. If you suspect that you have a bone stress injury, you should immediately stop running, jumping, and dancing activities until you can confirm whether there is a true bone injury. Here at Stretch, we are happy to help you with any running-related information. Give us a call at 513-874-8800 to set up an appointment Today!
- Winters, M. The diagnosis and management of medial tibial stress syndrome. Unfallchirurg 123, 15–19 (2020). https://doi.org/10.1007/s00113-019-0667-z
- Burrus, M. Tyrrell & Werner, Brian & Starman, Jim & Gwathmey, F. & Carson, Eric & Wilder, Robert & Diduch, David. (2014). Chronic Leg Pain in Athletes. The American Journal of Sports Medicine. 10.1177/0363546514545859.