Why Do My Shins Hurt? Understanding Shin Splints and Relief

Experiencing pain in the front of your lower legs? You’re not alone. Shin pain is a common complaint, especially among athletes and active individuals. Often, this discomfort is attributed to a condition known as shin splints. But what exactly are shin splints, and more importantly, why do your shins hurt? This article will delve into the causes, symptoms, and effective ways to manage and prevent shin splints, helping you get back on your feet, pain-free.

What are Shin Splints?

Shin splints, medically referred to as medial tibial stress syndrome (MTSS), are not actually splits in your shin bone (tibia). Instead, they describe pain along the shinbone, typically on the inner side of your lower leg. This pain arises from inflammation of the muscles, tendons, and bone tissue around your tibia.

Think of your shinbone as the sturdy front of your lower leg, running from just below your knee to your ankle. Shin splints occur when the muscles and tissues that attach to this bone are stressed and overworked. This stress leads to inflammation and pain, making activities like walking, running, or jumping uncomfortable. Shin splints are particularly prevalent in runners, dancers, and military recruits due to the high-impact nature of their activities.

[](Shin splints location on the lower leg)

Types of Shin Splints: Medial and Anterior

While the term “shin splints” is often used broadly, there are primarily two types, categorized by the location of the pain:

Medial Tibial Stress Syndrome (MTSS)

This is the most common type of shin splint. As the name suggests, medial tibial stress syndrome affects the medial or inner part of your shinbone. The pain typically occurs along the lower two-thirds of the inside edge of the tibia. MTSS is often linked to inflammation of the periosteum, the membrane covering the bone, and the muscles and tendons attaching to it in this area.

Anterior Tibial Stress Syndrome

Less common, anterior tibial stress syndrome involves pain on the anterior or front and outside edge of the shinbone. This type may be related to the muscles in the front compartment of the lower leg being overworked, such as the tibialis anterior muscle.

Understanding which type you might be experiencing can sometimes help in pinpointing the potential causes and tailoring treatment approaches.

Recognizing the Symptoms of Shin Splints

The hallmark symptom of shin splints is pain in the front of your lower leg. This pain can manifest in several ways:

Location of Pain: Pain is typically felt along the inner or outer front part of the shinbone.
Pain During and After Exercise: Pain often worsens during physical activity, particularly at the start of a workout. It may initially improve as you warm up but can return and intensify as you continue exercising or afterwards. In more severe cases, pain can persist even at rest.
Tenderness to Touch: The area along the shinbone is usually tender to the touch. Pressing along the inner or outer edge of the tibia will likely elicit pain.
Swelling: Mild swelling might be present in the painful area, although this is not always noticeable.
Dull Ache: The pain can range from a dull ache to sharp and throbbing, depending on the severity of the condition and activity level.

It’s important to note that shin splint pain can sometimes be confused with other conditions, such as stress fractures. If your pain is severe, constant, or doesn’t improve with rest, it’s crucial to seek medical advice to rule out more serious issues.

What Causes Shin Splints? Unpacking the Root Causes

Shin splints are generally caused by repetitive stress and overuse of the muscles and bone tissues in the lower leg. Several factors can contribute to the development of this condition:

Sudden Increase in Exercise Intensity or Volume: Ramping up your workout too quickly, whether it’s increasing mileage, intensity, or frequency, can overload your shin muscles and bones. This is a common trigger for shin splints, especially in new runners or those returning to exercise after a break.
Overpronation: This refers to the excessive inward rolling of the ankle and foot after landing. Overpronation can place extra stress on the shin muscles as they work harder to stabilize the foot and leg. People with flat feet are more prone to overpronation.

[](Illustration of overpronation and its impact on the leg)

Running on Hard or Uneven Surfaces: Exercising on concrete, asphalt, or uneven terrain puts more impact and stress on your lower legs compared to softer surfaces like trails or tracks.
Improper Footwear: Wearing shoes that lack adequate support, cushioning, or are worn out can contribute to shin splints. Shoes that don’t properly absorb shock or correct foot mechanics can increase stress on the shin.
Muscle Imbalances or Weakness: Weak calf muscles or imbalances between the calf muscles and muscles in the front of the shin can contribute to shin splints. These imbalances can alter biomechanics and increase stress on certain muscles.
Lack of Flexibility: Tight calf muscles or ankle stiffness can also contribute to shin splints by limiting ankle range of motion and increasing stress on the shin.

Seeking Diagnosis: When to See a Doctor

While many cases of shin splints can be managed at home, it’s important to know when to seek professional medical advice. Consult a doctor if you experience:

Severe Pain: Pain that is intense, debilitating, or prevents you from walking or performing daily activities.
Pain at Rest: Pain that persists even when you are not exercising and resting.
Night Pain: Pain that worsens at night, which could indicate a more serious condition.
Visible Swelling or Redness: Significant swelling, redness, or warmth in the shin area could be signs of infection or stress fracture.
Pain That Doesn’t Improve with Rest: If your shin pain doesn’t improve after a few weeks of rest, ice, and self-care, seek medical evaluation.

A doctor can properly diagnose your condition, rule out other potential causes of shin pain (like stress fractures, tendonitis, or compartment syndrome), and recommend the most appropriate treatment plan. Diagnosis usually involves a physical examination and discussion of your symptoms and activity levels. In some cases, imaging tests like X-rays or bone scans might be ordered to exclude stress fractures or other bone issues.

Treating Shin Splints: Steps to Relief and Recovery

The primary goal of shin splint treatment is to reduce pain and inflammation and allow the tissues to heal. Here are effective strategies for managing shin splints:

Rest: The cornerstone of shin splint treatment is rest. Reduce or completely stop the activity that is causing your pain. This allows the inflamed tissues to recover. Switch to low-impact activities like swimming or cycling to maintain fitness without stressing your shins.
Ice: Apply ice packs to the painful area for 15-20 minutes at a time, several times a day. Ice helps to reduce inflammation and pain. Always wrap the ice pack in a cloth to protect your skin.
Over-the-Counter Pain Relief: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. Follow the dosage instructions on the packaging and consult your doctor or pharmacist if you have any questions or pre-existing conditions.
Proper Footwear and Support: Wear supportive athletic shoes that are appropriate for your activity. Consider using shock-absorbing insoles or orthotics to provide additional arch support and cushioning, especially if you have flat feet or overpronation.
Stretching and Strengthening Exercises: Once the initial pain subsides, begin gentle stretching and strengthening exercises to improve flexibility and muscle strength in your lower legs. Focus on calf stretches, ankle mobility exercises, and strengthening exercises for the calf muscles and muscles around the shin. A physiotherapist or exercise physiologist can guide you on appropriate exercises.

[](Physiotherapist assisting patient with shin splint exercises)

Gradual Return to Activity: When you resume exercise, do so gradually. Start with low-impact activities and slowly increase the intensity, duration, and frequency of your workouts over several weeks. Listen to your body and back off if pain returns.
Physiotherapy: A physiotherapist can play a crucial role in shin splint recovery. They can assess your condition, provide targeted exercises, recommend orthotics if needed, and guide you on a safe return-to-activity plan.

Preventing Shin Splints: Proactive Measures

Prevention is always better than cure. You can significantly reduce your risk of developing shin splints by adopting these preventive strategies:

Gradual Exercise Progression: Avoid sudden increases in your training intensity or volume. Increase your mileage, speed, or workout duration gradually, following the “10% rule” (increasing weekly mileage by no more than 10%).
Proper Footwear: Invest in good quality, supportive running shoes that are appropriate for your foot type and activity. Replace your shoes regularly, typically every 300-500 miles, or when they show signs of wear and tear.
Orthotics and Insoles: If you have flat feet or overpronation, consider using orthotic inserts or arch support insoles in your shoes to improve foot alignment and reduce stress on your shins.
Warm-up and Cool-down: Always warm up properly before exercise and cool down afterwards. Warm-ups prepare your muscles for activity, while cool-downs help them recover. Include dynamic stretches in your warm-up and static stretches in your cool-down.
Cross-Training: Incorporate low-impact activities like swimming, cycling, or elliptical training into your workout routine to reduce the repetitive stress on your shins.
Strength Training: Strengthen your calf muscles, ankle muscles, and core muscles. Stronger muscles provide better support and stability, reducing the risk of shin splints.
Listen to Your Body: Pay attention to pain signals. If you feel shin pain developing, reduce your activity level and rest. Don’t push through pain, as this can worsen the condition.

Potential Complications of Shin Splints

While shin splints themselves are not typically serious, if left untreated or ignored, they can lead to complications:

Chronic Pain: Persistent shin splints can become chronic, leading to ongoing pain and limitations in activity.
Stress Fractures: In severe cases, the repetitive stress of shin splints can weaken the bone and potentially lead to stress fractures in the tibia. Stress fractures are small cracks in the bone and require longer recovery periods and more intensive treatment.
Impact on Activity Levels: Shin splints can significantly hinder your ability to exercise and participate in sports, impacting your fitness and overall well-being.

By understanding the causes, symptoms, and management strategies for shin splints, you can take proactive steps to address shin pain and keep yourself active and pain-free. Remember, if you’re experiencing persistent or severe shin pain, seeking medical advice is always the best course of action.