• Shin Splint

    (Medial Tibial Stress Syndrome)


    A shin splint is inflammation and pain along the inner part of the lower leg. It involves the shin bone, which is also known as the tibia.


    Shin splints occur when the tissue that connects muscles to the lining of the tibia becomes irritated and inflamed.
    Muscles of the Lower Leg
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    Risk Factors

    Factors that may increase your risk for a shin splint include:
    • Improper stretching or failure to warm up before exercising
    • Activities that involve repeated pounding of the legs on hard surfaces such as running, basketball, or tennis
    • Increasing intensity of exercise or mileage of running without proper preparation and conditioning
    • Worn-out or ill-fitting footwear
    • Improper running technique or problems with the way the foot hits the ground when running
    • A strength imbalance between two opposing muscle groups in the leg
    • Flattened foot arches
    • Running on a slope


    Symptoms of a shin splint include:
    • Pain on the inner side of the shin, described as aching or throbbing with local tenderness
    • Swelling or redness of the shin—not common


    If you have the symptoms of shin splints, you may not need to see a doctor. If the injury does not respond to self-treatment (see Treatments below) after two to four weeks, see your doctor. You may have a more serious injury.
    Your lower leg will be examined to look for areas of tenderness and swelling. In addition, the doctor will look for foot problems such as over-pronation.
    Images may be taken of your leg. This can be done with x-rays.


    RICE therapy

    • Rest—Take a break from the activity that caused the pain. This is often enough to clear up the shin splint within several weeks.
    • Ice—Apply ice in 15-minute periods during the first 24 hours and for several days after if needed. Do not apply ice directly to the skin. This helps reduce swelling, inflammation, and pain.
    • Compression—Wearing an elastic compression bandage may help prevent swelling and provide support for the shin and nearby soft tissues.
    • Elevation—Keep the injured leg raised for the first 24 hours, including during sleep. If there is local swelling, this may help.


    In addition to RICE therapy, you may take anti-inflammatory medications to relieve pain if recommended by your doctor. Always use as directed.


    If over-pronation is causing your shin splints, you can get custom-made arch supports, called orthotics, which help correct the over-pronation.


    The following steps may help to prevent the development of a shin splint:
    • Warm up gradually first and then do progressive stretching.
    • Slowly increase the intensity and duration of exercise.
    • Cool down after exercise with light stretching.
    • Run on a softer surface such as grass, dirt, or certain outdoor tracks.
    • Carefully select footwear. Different shoes have different degrees of support and motion control.
    • Avoid over-striding, which can put more stress on your shin.
    • Wear orthotics if your doctor recommends them.


    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

    American Orthopaedic Society for Sports Medicine http://www.sportsmed.org


    Canadian Society of Exercise Physiology http://www.csep.ca

    Healthy Canadians http://www.healthycanadians.gc.ca


    Couture CJ and Karlson KA. Tibial stress injuries: decisive diagnosis and treatment of 'shin splints'. Phys Sportsmed. 2002 Jun;30(6):29.

    Moen MH, Tol JL, Weir A, Steunebrink M, De Winter TC. Medial tibial stress syndrome: a critical review. Sports Med. 2009;39(7):523-546.

    Shin splints. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00407. Updated May 2012. Accessed December 16, 2013.

    Shin splints. American College of Foot and Ankle Surgeons Foot Health Facts website. Available at: http://www.foothealthfacts.org/what-is/ns%5Fshin-splints.htm. Accessed December 16, 2013.

    Shin splints. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 3, 2012. Accessed December 16, 2013.

    Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst Rev. 2011;(7):CD001256.

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