Shin Splints (Medial Tibial Stress Syndrome)

Shin splints is a condition that causes pain in the front part of the lower leg (shin). It is thought to be caused by repeated stress on the bone and the tissues around the bone in the lower leg (tibia). Shin splints often affect athletes and runners and are commonly due to overuse. A less common cause is flat feet with low arches.

Symptoms of shin splints often start as a dull ache that gets worse over time. Pain may also be sharp or stabbing. Resting your legs often relieves the symptoms. Pain may occur both during or after activity. Later, the pain may become continuous with almost any activity.

Your doctor will ask you questions about your activities and your health history. Tell your doctor about possible injuries. The diagnosis is often made through the history and physical exam. There are no specific tests for shin splints. Your doctor may want to do some tests to rule out other injuries, such as a stress fracture in your shinbone. These tests may include an X-ray, bone scan, or MRI scan.

Follow these and any other instructions you are given.

• Rest. Cut down on running and high-impact sports. Or stop doing these things completely to let your legs rest and the injury heal. You could try doing another activity, such as swimming, while you heal.
• Ice. Put ice on the painful areas. Ice for 10 to 20 minutes several times a day as needed. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on the skin. You can also elevate your leg above the level of your heart while you use the ice.
• Medicines. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, as directed by your doctor. If you have chronic liver or kidney disease, talk with your doctor before using these medicines. Also talk with your doctor if you've had a stomach ulcer or digestive bleeding, or are taking a blood thinner.

To help prevent shin splints in the future:

• Warm up before you run. Do gentle exercises.
• Return to training at a lower level of intensity and build slowly.
• Don't run on hard or uneven surfaces. Consider cross training, such as by cycling or swimming, on some days.
• If you have flat feet or low arches, consider orthotics or insoles for correction.

Use running shoes with good support and cushioned soles. Replace old or worn shoes.