Reading Time: 8 minutes
Shin Splints is a painful and frustrating overuse injury afflicting runners, dancers, and athletes participating in jumping sports. Medically termed medial tibial stress syndrome (MTSS), shin splints occur from repetitive impact activities placing excessive strain on the shinbones and connecting lower leg muscle tendons.
Resulting microtears and inflammation along the tibia perimeter causes tenderness, swelling, and debilitating ache exacerbating with continual play ultimately hampering performance. Although an annoyingly common nuisance injury, with proper rest and rehabilitative care, shin splints can fully heal within 6-8 weeks.
Shin Splint Warning Signs
The cardinal shin splint symptom involves diffuse burning or stabbing pain along the inner lower leg bone. Typically, a vague soreness arises during activity and then progresses to sharper pangs. Swelling and tenderness often emerge concentrating near the muscular attachments onto the tibia.
Additional indicators include:
- Tender periosteum skin overlying the affected shinbone area
- Lingering aches after exercise ceases
- Limping or altered gait patterns compensating for pain
- Light bruising surfacing on the anterior or posterior lower leg
- Inflammation and irritated areas are apparent upon palpation
See a sports medicine physician promptly if you experience:
- Inability to stand or walk without severe discomfort
- Intense throbbing pain ascending up the calf or down towards the ankle
- Visible redness and swelling rapidly expanding across the medial tibia
- Numbness or tingling sensations radiating below the knee
- Unrelenting nocturnal pain disrupting sleep patterns
Catching shin nuisance injuries early optimizes rapid recovery before spiraling into higher-grade lesions or secondary bone bruising and stress fractures. Don’t delay seeking advice once you feel that first familiar twinge.
High Risk Causes Underlying Shin Splints in Athletes
|35% of runners
|31% of players
|28% of athletes
|24% of dancers
The primary offender involves excessive physical stress overwhelming muscles and tendon junctions before fully adapting. Precise etiological mechanisms differ based on specific risk factors including:
Sudden Training Spikes
- Rapid accelerations in weekly running distances, pace, or hill work
- Intensifying plyometrics sessions with lots of jumping too quickly
- Increasing court time and spin classes without gradual build-up
- Prolonged practices on unforgiving concrete without rest
- Dancing or aerobics on marble, tile, or rubber floors lacking proper give
Poor Technique & Form
- Overstriding running patterns jarring the shins
- Heel striking gait flaws transmitting excessive ground force impacts
- Outward knee bowing in tired runners raises rotational forces
- Overpronation and flat foot biomechanics disrupting shock attenuation
- Worn-out sneakers lose cushioning capacity after 300-500 usage miles
- Lack of arch support from flat casual shoes
By recognizing the primary and associated causes provoking your shin trauma, specific remediation strategies prevent recurrence. Track training factors, assess technique changes, and evaluate equipment wear patterns when symptoms surface.
Conservative Home Treatment Options for Shin Splints
Mild shin splint cases often resolve within several weeks using conservative interventions dampening irritated lower leg tissue and restricting aggravating activities.
Recommended therapeutic techniques include:
Immediate Activity Modification
Cease any high-impact exercise triggering shin and calf pain for at least 6-8 weeks minimum. Eliminate running, court sports, and aerobics classes until the periosteal membrane and affected muscles stabilize without discomfort walking or performing daily living tasks.
Lower intensity cross training is safer for maintaining fitness including:
- Ellipticals and rowing ergometers
- Low-impact stair climbers and bikes
- Gentle swimming and water running
- Restorative yoga or Pilates
Apply frozen water bottles or gel ice packs wrapped in thin towels along the shin and calf. Use gentle pressure massaging for 10-15 minutes to relieve swelling and dull sensitivity. Repeat ice treatments several times daily – especially following activity-inducing pain flares.
OTC Anti-Inflammatory Medication
Short-term NSAID tablets like ibuprofen or naproxen reduce irritation enabling light mobility. Follow standard dosing instructions not exceeding 7-10 days to avoid gastrointestinal complications.
Targeted Stretching and myofascial Release
Gentle sustained stretches elongating tight calf muscles linked with shin splints provide relief. Likewise, using lacrosse balls or foam rollers massaging down the calf and along the foot plantar fascia loosens restrictions improving functionality.
Using Kinesiology Tape (KT Tape)
Apply flexible tape helping lift skin improving circulation, supporting muscles, and altering sensory input to reduce pain. Use specific taping placement techniques depending on location of shin splint symptoms.
Medical Interventions For Persistent Cases
See a sports medicine physician or physical therapist if pain, swelling, and movement limitations continue beyond 6-8 weeks of home therapy. They prescribe advanced aids expediting rehabilitation:
- Diagnostic musculoskeletal ultrasound imaging
- Custom orthotic shoe inserts realigning poor foot biomechanics
- Taping techniques stabilizing excessive joint motions
- Rigid shinbone braces or splits protecting the injury site
- Potential corticosteroid injections dampen extreme inflammation
- Graded return to running programs building impact tolerance
Avoid shin splint complications like chronic exertional compartment syndrome or secondary stress fractures necessitating extensive rehabilitation. Don’t delay seeking expert guidance tailoring interventions combating your specific short and long-term impediments athletically.
Treatment Strategies for Shin Splint Relief
Sports medicine specialists fortunately have an expanding array of targeted modalities accelerating recovery even among the most stubborn shin splint cases including:
Extracorporeal Shock Wave Therapy
Low-energy sonic pulse waves applied to the injury epicenter trigger revascularization, bone remodeling enzymes, and cell regeneration cascades. Clinical trials demonstrate 50-60% composite pain scale reductions within 6 weeks.
Platelet-Rich Plasma Injections
Concentrating platelet-derived healing growth factors from the patient’s centrifuged blood stimulates localized tissue repair when precisely injected into damaged areas. PRP regenerates bone, muscle, ligaments, and tendon tears showing a 70% success rate for protracted medial tibial pain per multiple sports medicine studies.
Injecting simple dextrose solution surprisingly strengthens ligament and tendon attachments at the bone junction where microtearing manifests in stubborn cases. Randomized trials display significant long-term reductions in rest and activity pain scores.
Implanting lab-cultured bone marrow stem cells, platelet lysate, amniotic fluid concentrates, and tissue engineering scaffolding promotes site-specific injury regeneration. Although research remains limited thus far, ortho biologics holds tremendous promise in rebuilding intractable shin splint lesions.
While clinical judgment decides optimal medical treatments per patient, recalcitrant cases failing extended conservative care warrant exploring advanced biologics regenerating battered tibial periosteum and leg musculature back to full integrity after a severe shin splint injury.
Optimal Return-To-Play Plans
Existing generalized clinical guidelines detailing appropriate recuperation periods and activity progressions following lower limb injuries lack specificity. Quantifying rest phases based on individual healing rates and controlled build-up prevents relapse.
We designed this adaptable shin splint rehabilitation protocol:
- Accumulate 30 minutes of non-impact activity like biking or swimming without pain before progressing
- Walk outdoors on level surfaces for 30 continuous minutes without discomfort, swelling, or post-exercise soreness
- Run slowly for 5 minutes + walk 5 minutes for 30 total minutes on soft dirt or grass without symptoms
- Cautiously up running duration weekly in ≤10% increments based on pain-free thresholds
- When a continuous running period lasts 30 minutes, adding a gentle pace increases
- Restrict any volume or intensity spikes over 10% weekly thereafter
- Closely monitor for hints of the return of symptoms
Through graduated sequences based on feedback from tissue healing rates, full activity restoration is optimized safely. Starting too aggressively risks re-injury. Thorough clinical evaluations determining underlying risk factors are also paramount to curb recurrence.
Causes of Persistent Medial Tibial Stress Syndrome
Why do some runners and athletes face frequent and protracted bouts despite diligent therapy while colleagues heal quickly and train chronically without incident?
Seeking out potential maladaptive issues provides an opportunity to correct biomechanical liabilities improving durability.
Overpronation & Foot Biomechanics
Excessive inward foot arch collapse places abnormal rotational forces on lower limb stabilizers. Custom orthotics re-establishing optimal alignment alleviates overload.
Leg Length Discrepancies
Femoral or tibial asymmetry alters gait mechanics increasing shear stress. Heel lifts below shorter limbs equalize forces.
Weak Gluteal Stabilizers
Poor core and hip strength allows knee collapse and internal rotation torque over-straining shin muscles. Targeted EMG biofeedback retraining maximizes stability.
Dynamic Bow Leggedness
Lateral knee displacement from hip external rotation fatigue or glute/adductor weakness amplifies ground reaction forces.
Localized Lower Leg Instability
Imbalances between anterior and posterior musculature reduce shock absorption. Split routines building eccentric control using tilt boards enhance robustness.
By identifying your specific anatomical and neuromuscular insufficiencies perpetuating shin trauma through advanced movement analysis and muscle function tests, tailored corrective interventions boost resilience.
Healing Shin Splint Through Sports Medicine
Assimilating emerging modalities from integrative disciplines further expedites recovery surrounding athletes in comprehensive healing milieus including:
Targeted Nutrition Support
Specific amino acids like proline and lysine accelerate collagen formation while carnosine combats advanced glycation end-product concentrations shown in rodents to inhibit injury repair. Curcumin potently squelches inflammatory cytokine cascades worsening pain.
Instrument-Assisted Soft Tissue Mobilization
IASTM scrape release treatments enhance fibroblast mobility and tissue permeability improving micro-circulatory delivery of nutrient-rich oxygenated blood critical for healing injured zones.
Electrotherapy Muscle Stimulation
The electric impulse to shin musculature maintains mass, strengthens neural drive, and downregulates dorsal horn pain receptor signaling decreasing sensitivity to discomfort.
Proprioceptive & Vestibular Training
Fine-tuning movement pattern quality through neuromuscular re-education optimizes shock attenuation while challenging balance reactions enhance subconscious postural control restoring smooth striding mechanics protective against reaggravating acquired lesions.
Mindfulness Meditation & Yogic Breathing
By reducing baseline sympathetic tone, heart rate variability biofeedback paired with relaxing diaphragmatic breathing elicits systemic anti-inflammatory effects while subjectively decreasing nociceptive facilitated states lowering referred discomfort.
Advanced Imaging & Testing For Recalcitrant Cases
In scenarios where standard evaluations fail to elucidate pain etiologies, advanced technologies provide superior sensitivity in detecting pathological tissues.
High-Resolution MRI Spectroscopy
This specialized imaging using tailored radiofrequency pulsations assessed by Fourier mathematical transformations discerns bone marrow edema signaling microdamage otherwise invisible on standard MRIs aiding injection guidance under fluoroscopy and improving clinical outcomes.
PET/CT Fusion Imaging
Combining anatomical Computed Tomography detail overlayed with Positron Emission Tomography highlighting abnormal metabolic activity pinpoints exact injured locations useful when symptoms remain nebulous.
Wireless SEMG Analysis
Real-time electromyography readings transmitted wirelessly to tablets and computers parses left to right imbalances identifying specific dysfunctioning musculature for focused correction.
Instrumented Treadmill Testing
Multi-plane force plates measuring ground reaction forces at precise time intervals while capturing simultaneous body marker motion illuminates specific gait abnormalities – especially regarding pronation timing relative to heel strike.
By pinpointing structural pathology otherwise hidden and clarifying complex loading patterns overwhelming tissue tolerances, cutting-edge imaging and diagnostics empower targeted interventions to correct deficiencies protecting against recurrence.
Scientific Training Principles Preventing Shin Splints
Alongside personalized therapeutic remedies, proactive training fundamentals provide the cornerstone of keeping shins healthy with sports participation.
Gradual Sport-Specific Skill Adaptation
Progressively increase weekly volume, pace, or movement complexity in ≤10% increments allowing proper musculoskeletal-neuromuscular acclimation without overload.
1-2 Rest Days Post High-Intensity Sessions
Dedicated recovery days maintain tissue homeostasis preventing maladaptive responses to accumulated microtrauma.
Periodized Seasonal Training Programs
Thoughtfully planned mesocycles intentionally varying discipline emphasis using exercise science principles prevent overuse patterns through managed recovery periods while optimizing peak performance.
Cross-Training Modality Variation
Alternating running, swimming, biking, and gentle yoga diversifies biomechanical and emotional stresses mitigating disproportionate singular overload and keeping shins resilient.
Commit towards training intelligently – not intensely. By gradually building chronic workload tolerances through reasonable increases in mesocycle stress and recovery while regularly changing training stimuli, shin splint risk plummets. Easy days remain critical for homologous tissues to adapt productively. Listen carefully towards warning signals from your body and quickly adjust at the first sign of symptoms. Consistent training blocks bereft of relenting infliction engender brittle bodies. Embrace rest restoring readiness to perform optimally. Champion calculated training guided by a commitment towards lifelong athleticism. Our integrative sports medicine team stands ready to help you cross the finish line through compassionate care should injury surface. Yet we prefer empowering your human potential reaching aspirational goals uninhibited by physical limitations. We wish you the best in pursuing passions free from pain.
Shin Splints – Common term for medial tibial stress syndrome (MTSS); an overuse injury causing pain along the tibia bone due to inflammation.
MTSS – Medial Tibial Stress Syndrome; the medical terminology for pain along the shinbone (tibia) caused by repetitive impact.
Periosteum – Outer membranous lining enveloping bone tissue.
Tibia – Shinbone; becomes irritated and inflamed due to traction from muscle attachments during shin splints.
Stress Fracture – Tiny crack propagating through bone.
Periostitis – Inflammation specific to the periosteum tissue surrounding bone.
NSAIDs – Non-steroidal anti-inflammatory drugs like ibuprofen are used to reduce swelling and pain.
Cortisone Injections – Potent anti-inflammatory steroid preparations injected into injured sites.
PRP injections – Platelet-rich plasma derived from the patient’s own centrifuged blood containing concentrated tissue healing growth factors.
Prolotherapy – Technique strengthening ligament and tendon attachments via dextrose solution.
ESWT – Extracorporeal shock wave therapy; pulsed sonic pressure waves accelerate delayed injury repair.
Orthobiologics – Treatments using lab-engineered cells, cytokines, and tissues to heal damaged structures.
DOMS – Delayed onset muscle soreness from microscopic muscle fiber tears.
American College of Sports Medicine (ACSM)
National Institutes of Health (NIH)
American Academy of Orthopaedic Surgeons (AAOS)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
With proper treatment, mild shin splints typically heal within 4 to 6 weeks. More severe cases can take 3 to 6 months to fully heal. Rest, ice, compression, and elevation help speed healing.
If left untreated, shin splints can last for several months or longer. With rest and treatment, most cases resolve within 6 weeks, though it may take a few months for the area to feel completely normal again.
Rest and avoid activities that aggravate them, ice the shins for 15-20 minutes several times per day, take anti-inflammatory medication, stretch and strengthen the leg muscles, wear supportive footwear, use compression sleeves, and consider orthotics.
Healing shin splints requires rest, icing, OTC pain medication, stretching and strengthening exercises for the lower legs, proper footwear, compression sleeves, activity modification, and patience. Complete recovery can take 4 to 6 weeks for mild cases or a few months for severe shin splints.
With appropriate rest and treatment, most people recover from mild to moderate shin splints within 4 to 8 weeks. Severe shin splints can take 3 to 6 months to fully heal. Factors like a person’s fitness level and activity modification impact individual recovery times.
Muskan Thakur is a skilled physical therapist based in Los Angeles, USA. She completed her Bachelor of Physical Therapy (BPT) from Delhi University in 2010. Ms. Thakur furthered her studies by completing a clinical residency program focused on orthopedic physical therapy at Duke University in the United States in 2012. She then attained her Master’s in Public Health (MPH) from the Institute of Public Health in Delhi in 2015. With over 10 years of experience, Ms. Thakur employs a holistic approach combining manual therapy, therapeutic exercise, education, and lifestyle modifications to treat neurological, orthopedic, and musculoskeletal conditions.