Shin Splints

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Darlene Rempel, C Ped (C) Jean Grant

Shin Splints

What causes Shin Splints? Shin Splints describes a variety of non-specific pain that occurs in or around the shin bone (tibia). Usually caused by overuse of the tendon or poor foot mechanics, the pain from shin splints can be located on the bone, the muscle in the front of the lower leg or the inside of the ankle or arch. Therefore, shin splints is a general diagnosis.

What most athletes call 'shin splints' is better described as Medial Tibial Stress Syndrome (MTSS). With MTSS the pain is felt on the lower one third of the medial or inside part of the tibia. In mild cases, the pain starts immediately at the start of an activity and will gradually decrease once the muscle gets warmed up. In more advanced cases, such as a stress fracture, the pain will be at rest, there will be swelling, and an inability to train due to pain.

Where would I feel the pain?

The pain would be most prevalent in the front of the shin. Usually the sharp part of the shin bone, near the ankle or the inside of the ankle.
The muscle involved with MTSS is Tibialis Posterior. This muscle originates along the border of the tibia (shin bone) to just above the inside of the ankle bone where it becomes a tendon. The tendon then continues down and inserts into the arch bones.

What causes Shin Splints?

Improper training usually increasing mileage or increasing the intensity too quickly may cause the tendon to tire without enough recovery time. Another major cause of MTSS is improper foot/leg biomechanics. This may include too much pronation (arches falling) or not enough pronation (high arch). With excessive pronation, the dropping of the arch will overstress the Tibialis Posterior whose main job is to maintain arch support and lift the heel during running and walking.

With a high arch, the Tibialis Posterior tendon is already under stress as it is tight from the characteristics of the high arch. With the added stress of increased activity, such as running, there is too much demand on the Tibialis Posterior causing MTSS.
Improper footwear can be a factor in your injury. The footwear must match the foot type and take into account your individual activity and mechanics.

What can be done to treat Shin Splints?

Custom Foot Orthotics and proper footwear can help to correct poor foot mechanics after an evaluation by a Canadian Certified Pedorthist. Athletic Therapists and Physiotherapists use exercise and modalities to resolve muscle imbalances and decrease inflammation.
Cross training is an excellent way to train and reduce the stress on your shin splints. It is said that 20 minutes of running in a pool produces the same aerobic effect as one hour of running on the roads. For a change try riding a bike. An excellent way to ride during the winter months is to join a 'spinning class'.
Finally, the best way to look after your MTSS is to ice and rest your legs. Massage also assists in breaking down scar tissue and promoting circulation.

Ignoring shin pain can lead to the development of a stress fracture and recovery from that may take up to 6 weeks of rest from activity.