Slowing Down Shin Splints

Shin splints – that pain in the shins that flares up during exercise - are a classic overuse injury, usually occurring when people push their legs too hard for too long. A case of shin splints isn't serious, but it can be extremely aggravating. Whether you're a casual jogger or an elite athlete, you don't want shin splints to slow you down.

Franciscan Health sports medicine physician Jenna Walls, MD, discusses shin splints, what to do if you have pain in your shins, and how you can prevent shin splints during exercise.

What Do Shin Splints Feel Like?

Many people describe shin splints as a vague, aching feeling. If you have a stress fracture, the pain may be sharp and localized. Shin splints most often occur along the inside of the shin above the ankle, or along the outside of the shin below the knee.

“Shin splints are caused by repetitive stress on the shinbone and on the soft tissues that attach muscles to the bone,” Dr. Walls said.  “The main symptom of shin splints is dull, persistent pain along the front of the lower leg, below the knee and along the shinbone. This pain usually begins during and/or after intense exercise, like running.”

In most cases, the problem develops gradually after a few weeks or months of intense exercise, but some people can feel the pain after one especially rigorous run. A person with shin splints usually feels pain when starting a workout. The pain may fade as the exercise continues, but it often comes back with a vengeance when a person finally rests. Many people wake up very sore the next morning.

Why Do Runners Get Shin Splints?

With so many recreational runners out there, there's no shortage of potential sufferers of shin splints. A report in Medicine and Science in Sports and Exercise found that shin splints account for up to 16 percent of all injuries in runners.

According to the report, shin splints are especially common in novice runners and, at the other end of the spectrum, competitive runners. Runners who are in poor shape or who have had previous leg injuries are also prime targets. You may also be especially susceptible if you run on hard surfaces like concrete and asphalt.

Other risk factors for developing shin splints include:

• Sudden increase in training intensity and duration
• Running on uneven terrain
• Wearing improper running shoes
• Having flat feet or high arches
• Having a previous lower leg injury
• Participating in military training

Shin splints don't bother only joggers -- other high-impact sports like basketball, soccer, tennis and racquetball can cause problems.

How Are Shin Splints Treated?

The best treatment for shin splints is giving your legs a rest, Dr. Walls said.

“Treatment of shin splints typically involves rest, applying ice to the shin, and taking pain-relieving medications as needed,” she said. “If the affected athlete is a runner, we generally recommend that they stop running or reduce the number of miles that they run until their symptoms improve. Athletes can often try another type of exercise that does not stress the shins, like riding a bike or swimming, while they wait for their symptoms to improve.”  

Over-the-counter pain medications like aspirin or ibuprofen can help ease any lingering pain. You can also try putting an ice pack on the sore spot for 20 minutes twice a day.

“An athlete with shin splints probably does not need to see a doctor, unless they think that there is a chance they have broken a bone,” Dr. Walls said. “A broken bone is more likely if there has been an injury around the time that symptoms first started. Some athletes can get stress fractures, meaning that they break a bone just by exercising or running too hard over a period of time. Stress fractures feel different from shin splints, as pain from stress fractures is usually very intense and mainly occurs in one spot along the shin.” 

If the pain in your shin doesn't go away within a few weeks, schedule an appointment with your doctor.

Can You Prevent Shin Splints?

Being reasonable in the way you exercise is one of the best defenses against shin splints. The American Academy of Orthopaedic Surgeons recommends that you stretch and warm up for five minutes before going for a run. If you want to improve your conditioning, increase your distances gradually.

“Exercises to strengthen and stabilize the legs, ankles, hips and core can help prepare the legs to better deal with high-impact activities,” Dr. Walls said.

As your legs get stronger, they can withstand more abuse -- although it's always good not to overdo it. Shin splints are likely to occur when runners start to increase their mileage -- say, from one or two miles a day to three or four miles a day. It's a good idea to follow the "10 percent rule," or boosting your activity level 10 percent at a time. If you normally jog one mile, for example, begin by increasing that to one-and-one-tenth miles rather than four.

Proper shoes can save you a lot of pain. Choose a pair that provides plenty of support and cushioning.

“Athletes may be able to reduce their chances of getting shin splints by wearing shoes with extra cushioning, running on softer surfaces, and gradually increasing the amount of exercise they are doing over time,” Dr. Walls said. “Wearing insoles or arch supports may be helpful in some cases.”

In addition to wearing proper shoes, Dr. Walls encourages a healthy diet for athletes for injury prevention.

“Some studies have also shown that a well-balanced diet that provides enough daily calories may reduce an athlete's chance of getting shin splints,” she said.

If you haven't been exercising much lately, it's only natural to want to make up for lost time. But remember: It's hard to stay in shape when your shins are screaming. Keep your goals realistic, keep your shoes in good shape, and keep your shins happy.