Shin splints

Shin splints are pain along the shin bone, also called the tibia. The tibia is the large bone in the front of the lower leg. Shin splints are common in runners, dancers and military trainees.

Known in medicine as medial tibial stress syndrome, shin splints often occur in athletes when they start training harder. The increased activity puts stress on the muscles, tendons and bone tissue.

Rest, ice and other self-care measures most often can treat shin splints. Wearing the right shoes, not increasing training too quickly and altering exercises can help prevent shin splints from coming back.

If you have shin splints, you might notice tenderness, soreness or pain along the inner side of your shinbone and mild swelling in your lower leg. At first, the pain might stop when you stop exercising. It might feel better with stretching.

But in time, the pain can be ongoing. You might be getting a stress reaction or stress fracture.

When to see a doctor

Call your healthcare professional if rest, ice and pain relievers you can get without a prescription don't ease your shin pain.

Shin splints are caused by continuing stress on the shinbone and the tissues that attach muscles to the bone, called connective tissues.

The risk of shin splints is higher for people who:

• Run, especially when starting a running program.
• Quickly increase how long, how often or how hard they exercise.
• Run on uneven ground, such as hills, or on hard surfaces, such as concrete.
• Are in military training.
• Have flat feet or high arches.

To help prevent shin splints:

• Make sure you're moving right. A sports medicine professional can watch a video with you of you running to help find areas in which you can improve to lower the risk of shin splints. Often, small changes in how you run and exercises to build strength can lower your risk.
• Don't do too much. Too much running or other high-impact activity done for too long, too hard can overload the shins.
• Choose the right shoes. Use a shoe that's comfortable, well cushioned and is suited to your foot. If you're a runner, replace your shoes about every 350 to 500 miles (560 to 800 kilometers).
• Think about arch supports. Arch supports might help prevent the pain of shin splints, especially if you have flat arches.
• Think about shock-absorbing insoles. They might reduce shin splint symptoms and prevent them from coming back.
• Lower the impact. Cross-train with a sport that puts less impact on your shins. Examples are swimming, walking or biking. Start new activities slowly. Increase how long and hard you do them little by little: About a 10% increase in the amount of impact activity per week is a good progression.
• Add strength training to your workout. Exercises to strengthen your legs, ankles, hips and core can help get your legs ready for high-impact sports.

Shin splints most often are diagnosed based on medical history and a physical exam. Sometimes, an X-ray or other imaging studies can point to other causes for the pain, such as a stress fracture.

Most often, you can treat shin splints with simple self-care steps:

• Rest. Don't do activities that cause pain, swelling or discomfort. But don't stop moving. While you're healing, try low-impact exercises, such as swimming, bicycling or water running.
• Ice. Apply ice packs to the affected shin for 15 to 20 minutes at a time, 3 to 4 times a day for several days. To protect your skin, wrap the ice packs in a thin towel.
• Take a pain reliever you can get without a prescription. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others) to reduce pain.

Go back to your usual activities little by little after your pain is gone.