Shin Splints

Contrary to common knowledge, shin splints are not a specific diagnosis but a feeling of pain over the front of the shin.  The pain referred to as shin splints arise from problems in the muscle, bone, or attachment of muscle to bone.  To provide a specific location, the pain is felt where the tibialis anterior muscle inserts into the tibia bone (just below the knee to ½ way down the leg).  When people speak of shin splints, they most commonly refer to an overuse injury and irritation of the tibialis anterior tendon and the attachment to bone.  Medically, the condition is termed medial tibial stress syndrome.  Pain over the front of the shin can also be caused by stress fractures or exercised induced compartment syndrome.  All of these injuries are typically due to overuse injury.


Ordinary, the tibialis anterior muscle is overused because the foot overpronates.   Pronation occurs when the foot flattens as weight is applied.  This is a normal event in walking but during overpronation the foot becomes so flat that it rolls inward.  The increased movement in the foot increases the demand on the tibailis anterior muscle and its connection to the tibial bone.


People with shin splints typically complain of tenderness along the bone and may have some swelling in the area.  This pain is most commonly increased when pushing the foot into the ground, like what is done during running.  In addition to taking a detailed medical history and physical, a doctor may order an x-ray or bone scan.  While not all shin splints are the same, basic treatments are.  Applying ice packs or ice massage the area for 20 min three times a day with anti-inflammatory medication will help reduce the pain.  This should be done in addition to making sure shoes are in good condition and the foot does not excessively pronate (a good shoe insert or orthotic should prevent overpronation).  As always, it is important to be evaluated by a doctor if pain is not temporary.