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Physio Matters

Shin splints

Medial tibial stress syndrome also known as shin splints is an overuse injury of the lower leg that often affects athletes involved in running or jumping activities.  Athletes with shin splints often report pain to the posteromedial (slightly behind and inside) edge of the tibia (largest lower leg bone) in the middle to distal one third of the bone.  The pain typically presents as a dull ache when exercising, and is relieved with rest.  However, often if the athlete continues to train despite the pain, symptoms will become more severe and persistent, and pain may occur even at rest following activity. 
There has been many theories as to why shin splints occur.  Most recently researchers have determined that the source of the injury occurs when weight bearing activities cause strain on the tibial bone causing the bone to bend.  This causes micro damage to the bone which ultimately leads to localized tibial osteopenia (low bone mineral density).  Other researchers point to the strength of the calf muscles and their ability to create traction on the tibial periosteum (connective tissue on the outer surface of the bone).  This tension of the periosteum can cause inflammation and irritation. 
Risk factors of shin splints have also been extensively researched.  It has been determined that there are multiple risk factors which are as follows: Excessive pronation of the foot, body mass index greater than 21, small calf girth, previous history of shin splints, and excessive internal or external rotation of the hip.  In addition, research indicates that females are more likely than men to experience shin splints.   
Additional risk factors include: Increased running distance or intensity, changing terrains or running shoes, as well as running in shoes that no longer provide support to your foot (ones that need to be replaced).
Treatment of shin splints may include rest, ice, compression, and elevation (RICE principle).  In addition stretching and physical therapy modalities such as ultrasound or laser may also be beneficial.  A stretching program that involves the hamstrings, gastrocnemius, and soleus may also be beneficial in reducing symptoms and preventing shin splints.  Strengthening exercises that involve dorsi flexion (flexing your ankle and pulling your toes up), plantar flexion (pointing your toes), inversion (sole of the foot inward), and eversion (sole of the foot outward) with exercise tubing can also help to prevent further injury.  Please consult with your primary health care provider to determine a diagnosis for your lower leg pain and an appropriate treatment plan.

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About the Author

Kristi Scott, B.Sc., M.Sc.P.T., CAFCI



You can contact Kristi by email at [email protected]



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