Shin Splints

Shin pain is an extremely common complaint among active people, especially those who do a lot of running. The term “shin splints” is often used to describe the pain along the medial (inside) border of the shin.

Whilst self management strategies and recognition of the onset of the condition are obviously important, self diagnosis can be risky as it is necessary to make a more precise differential diagnosis.

Shin pain generally involves one or more of 3 pathological processes*:

1. Bone stress – a continuum of increased bone damage exists from bone strain to stress reactions and stress fracture.
2. Inflammation - (Tenoperiostosis – inflammation of the periosteum of the bone.) Develops at the insertion of muscles, particularly to the medial border of the tibia (shin).
3. Raised intracompartment pressure – the lower leg has a number of muscle compartments, each enveloped by a thick inelastic connective tissue. These muscle compartments can become swollen and painful.

It is also important to be aware of less common causes of shin pain such as referred pain from lower back, nerves, knee and ankle joints or vascular involvement.

General causes include:

• Increased intensity/volume of training
• Over pronation/poor lower limb biomechanics
• Poor footwear
• Tight calves

Self management/treatment strategies include:

• Rest
• Ice
• Anti-inflammatories
• Massage

Like with all injuries, an accurate diagnosis is important. Correct treatment and management cannot be put in place without thorough assessment. There are various treatment options available so it is important to seek a physiotherapist’s assessment and treatment if your self management does not provide relief.

* Brukner, P. and Khan, K., Clinical Sports Medicine, Second Edition, The McGraw-Hill Companies Inc, 2000