What are Shin Splints?
Discover what causes shin splints and how to prevent them.
by Brad Walker | First Published May 27, 2002 | Updated May 28, 2019
Although the term shin splints is often used to describe a variety of lower leg problems, it actually refers specifically to a condition called Medial Tibial Stress Syndrome (MTSS).
For the purpose of this article I’ll focus on general shin soreness and shin splints.
Side note: Before I move on to shin splints, I want to quickly cover the topic of general shin soreness. Shin soreness is simply an overuse problem. By including adequate rest in your training calendar, and using the R.I.C.E.R. regimen when pain does occur, you’ll be able to overcome 90 percent of all general shin soreness within about 72 hours. For lower leg pain that goes beyond general shin soreness, a more aggressive approach must be taken.
Shin Splints Anatomy
To better understand shin splints an understanding of the muscles, tendons and bones involved is required.
As you can see from the diagram, there are many muscles and tendons that make up the lower leg, or calf region. The main components of the lower leg that are affected by the pain associated with shin splints are:
- The Tibia and Fibula. These are the two bones in the lower leg. The tibia is situated on the medial, or inside of the lower leg. While the fibula is situated on the lateral, or outside of the lower leg.
- The major muscles in the lower leg that are associated with shin splints are the: Gastrocnemius (Upper calf); Soleus (Lower calf); Tibialis anterior (Shin); Plantaris (Upper calf); and Tibialis posterior (Upper calf). It’s these muscles, when overworked, that pull on the tibia and fibula and cause the pain associated with shin splints.
What Causes Shin Splints?
The pain associated with shin splints is a result of fatigue and trauma to the muscles, tendons and fascia where they attach to the tibia and fibula. In an effort to keep the foot, ankle and lower leg stable, the muscles exert a great force on these bones. This excessive force can result in the tendons and fascia being partially torn away from the bone.
While there are many causes of shin splints, they can all be categorized into two main groups: Biomechanical Inefficiencies; and Overload (or training errors).
Poor running form and biomechanic inefficiencies are the #1 cause of shin splints. It doesn’t matter what shoes you wear, how much you warm up, or anything else you do, if your running form is poor you’re going to get injured.
The major biomechanical inefficiency contributing to shin splints is that of flat feet. Flat feet lead to a second biomechanical inefficiency called pronation. Pronation occurs just after the heel strikes the ground; the foot flattens out and then continues to roll inward.
Over-pronation occurs when the foot and ankle continue to roll excessively inward. This excessive inward rolling causes the tibia to twist, which in-turn, pulls the muscles, tendons and fascia of the lower leg away from the bone.
Other biomechanical causes include:
- Poor running mechanics;
- Tight, stiff muscles in the lower leg;
- Running with excessive forward or backwards lean;
- Landing on the balls of your foot; and
- Running with your toes pointed outwards.
Overload (or training errors)
Shin splints are commonly associated with sports that require a lot of running or weight bearing activity. However, it is not necessarily the added weight or force applied to the muscles and tendons of the lower leg, but rather the impact force associated with running and weight bearing activities.
In other words, it’s not the running itself, but the sudden shock force of repeated landings and change of direction that causes the problem. When the muscles and tendons become fatigued and overloaded, they lose their ability to adequately absorb the damaging shock force.
Other overload causes include:
- Exercising on hard surfaces, like concrete;
- Exercising on uneven ground;
- Beginning an exercise program after a long lay-off period;
- Increasing exercise intensity or duration too quickly;
- Exercising in worn out or ill fitting shoes; and
- Excessive uphill or downhill running.
How to Prevent Shin Splints
Prevention, rather than cure, should always be your first aim. I was very surprised when researching this topic at the number of articles that totally neglected any mention of preventative measures. They all talked of rehab and cure, but only one out of twenty took the time to address the issue of prevention in any detail.
Even before any sign of shin soreness appears there are a number of simple preventative measures that can be easily implemented.
- Make a dedicated effort to improve your running form. If you’ve suffered with shin splints for more than six months, or they repeatedly come back after you thought you’d finally got rid of them; chances are you have a biomechanical inefficiency that needs to be addressed. Get your gait analysed; get your foot type analysed, and have an experienced running coach give you some tips on how to improve your running form.
- Since about half of all lower leg problems are caused by biomechanics inefficiencies, it makes sense to get the right advice on footwear. Your feet are the one area you should not “skimp” on. The best advice I can give you concerning footwear is to go and see a qualified podiatrist for a complete foot-strike, or gait analysis. They will be able to tell you if there are any concerns regarding the way your foot-strike or gait is functioning. After your foot-strike has been analysed, have your podiatrist, or competent sports footwear sales person recommend a number of shoes that suit your requirements. Good quality footwear will go a long way in helping to prevent many lower leg problems.
- A thorough and correct warm up will help to prepare the muscles and tendons for any activity to come. Without a proper warm up the muscles and tendons will be tight and stiff, which may limit blood flow to the lower legs and result in a lack of oxygen and nutrients for those muscles. Before any activity be sure to thoroughly warm up all the muscles and tendons that will be used during your sport or activity.
- Strengthening and conditioning the muscles of the lower leg will also help to prevent shin splints. There are a number of specific strengthening exercises you can do for these muscles, including toe-up exercises; heel and toe walking; calf raises; and Thera-Band exercises.
- Flexible muscles are extremely important in the prevention of lower leg injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over-stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement. To keep your muscles and tendons flexible and supple, it is important to perform regular shin splint stretches.
Shin Splints Treatment
First and foremost; be sure to remove the cause of the problem. Whether it be a biomechanical problem, or an overload problem, make sure steps are taken to remove the cause.
If shin splints are causing you a lot of pain, you can use ice to help reduce the pain. BUT… please be aware that while ice will help to relieve some of the pain associated with shin splints, it will not fix them or cure them.
The next phase involves a number of physical therapy techniques. The application of heat and massage (or foam rolling) are very effective in speeding up the healing process of the muscles and tendons in your lower legs and shins.
I have found both from personal experience and from working with many clients, that this form of treatment is the most effective. The application of heat and deep tissue massage on the affected area brings the best results. If you suffer from shin splints, be sure to spend at least a few minutes massaging the affected area both before and after you exercise.
Once most of the pain has been reduced, it is time to move onto the rehabilitation phase. The main aims of this phase are to regain and improve the strength, power, endurance and flexibility of the muscles and tendons that have been compromised.
Fix Your Shin Splints Now!
The recommendations on this page are a good starting point, but if you’ve injured your shins or you’re trying to recovery from shin splints, take a look at my 7 Step Shin Splints Treatment System.
The 7 Step System is a systematic, step-by-step, proven method of reducing your pain, fixing your shin splints injury properly, and then making your lower legs so strong and stable you’ll never have to worry about shin pain again.
Visit the information page to find out more, or watch the shin splints treatment video to see how to fix your shin splints once and for all and restore pain free, unrestricted movement to your lower legs.
Research and References
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Porter, D. Schon, L. (2008). Baxter’s The Foot and Ankle in Sport, 2nd Edition (ISBN: 978-0323023580)
- Bahr, R. Maehlum, S. (2004) Clinical Guide to Sports Injuries, 1st Edition (ISBN: 978-0736041171)
- Wikipedia contributors. (2019, May 4). Shin splints, In Wikipedia, The Free Encyclopedia.
- Jones, O. (April 23, 2018). Muscles in the Posterior Compartment of the Leg. Retrieved May 28, 2019, from https://teachmeanatomy.info/lower-limb/muscles/leg/posterior-compartment/.
- Tolbert, T. Binkley, H. (2009). Treatment and prevention of shin splints. Strength & Conditioning Journal, 31(5), 69-72.
- Moore, M. (1988). Shin splints: diagnosis, management, prevention. Postgraduate medicine, 83(1), 199-210.
- Beck, B. (1998). Tibial stress injuries. An aetiological review for the purposes of guiding management. Sports Medicine, Oct;26(4):265-79.
- Thacker, S. Gilchrist, J. Stroup, D. Kimsey, C. (2002). The prevention of shin splints in sports: a systematic review of literature. Medicine & Science in Sports & Exercise, 34(1), 32-40.
- Eggold, J. (1981). Orthotics in the prevention of runners’ overuse injuries. The Physician and Sportsmedicine, 9(3), 124-131.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.