What causes shin Splints?

Shin splints is a general term for pain in the front of the tibia or shin. The pain could be related to muscle, tendon, periosteium, or bone. In some cases the pain could be caused by a stress fracture of the tibia. Most commonly it is caused by medial tibial stress syndrome (MTSS), which is an overuse injury to the muscle and tendons of the lower leg.

Signs and Symptoms of Shin Splints

The tibialis muscle gradually becomes more tender or sore with activity. It may begin as a dull ache or stiffness. The pain begins to increase in intensity to a moderate dull ache and sharp pain that limits activity. Swelling may be noticeable along the inside of the leg. The muscle may become very tender to the touch. Eventually it can become extremely painful to walk or run.

Video: Shin Splints from Running can be Treated with Graston Technique

Common Causes of Shin Splints

Overuse injuries are commonly seen in athletes who increase their intensity or duration of activity. It is common in runners who are running longer than they ever have before or increasing their hill running. It is common with impact sports with quick changes in direction such as tennis or basketball. Marathon runners are commonly injured due to their volume of training mileage.

Shin Splint Risk Factors

In addition to over training, several risk factors include:

  • Jumping activities
  • Running with worn out shoes
  • Overpronation or excessive collapse of the foot arch during walking or running

    • The foot normally flattens out slightly during running or walking, however, excessive collapse of the arch is called overpronation. The excessive movement causes increased stress on the muscles and tendons of the lower leg, eventually causing an overuse injury of the lower leg muscles resulting in shin splints.

Treating Lower Leg Pain at Home

Home care of shin splints includes icing the leg muscles, reducing activity, decreasing inflammation and leg pain. If the pain persists for two weeks or becomes severe seek a health care provider for treatment.

Ice for 15 minutes. Then take the ice off for 15 minutes to let the legs warm and increase blood flow. Apply the ice again for 15 minutes. Repeating this cycle several times a day can make a significant difference in your recovery. Icing can be in the form of ice packs or ice baths. Ice baths involve placing your legs in a bucket of ice and water. It should be cold but not painful.

Fracture or Shin Splints?

Persistent pain will require evaluation to rule out a stress fracture through physical exam, history or X-ray. X-rays will not always be needed, it will be determined on when, where, and how bad the pain is along the tibia.

Treating shin splints

Treatment of shin splints is aimed at decreasing inflammation, muscle spasms, and pain. Specific exercises and stretches improve foot strength and reduce over pronation. Modification of training schedule is often required, and arch supports may be considered to control the over pronation. As with any muscle injury, expect your provider to manually stretch and work the muscles. Various muscle techniques speed recovery including massage therapy, Graston Technique and active stretching. In our office, we will also utilize massage therapy to improve healing and recovery, in addition to decreasing the pain and muscle spasms. People feel they respond quicker to treatment and are back running sooner when massage therapy is utilized in their treatment.


It is important to wear proper footwear. Not all running shoes are equal or appropriate for every runner. Some shoes provide better arch support than others. Specialty running stores will watch you run and properly correct for your level of pronation with specific shoes.

Shin splints can be successfully treated while keeping you active. With proper treatment, we keep our athletes active and they do not have to take several weeks off training. For further questions, please call our office or visit our services page for further treatment description at our Services page.

For videos and descriptions of foot strengthening exercises see our Video page.