Shin splints

What are shin splints?

Shin splints, also referred to as medial tibial stress syndrome, can happen if you’ve recently increased your physical activity. Extra exercise can cause stress on the shinbone and overwork the muscles and tendons, which can get inflamed and become painful. 

What are the symptoms of shin splints?

The main symptoms are pain and tenderness on the front of your shin – your lower leg between the knee and ankle. At first, the pain occurs after exercise but over time the pain can come on during exercise too. 

What causes shin splints?

While the exact cause is not known, shin splints tend to be caused by overactivity. Shin splints typically affect runners and people who exercise or play sports that involve repeatedly putting stress on your legs, such as tennis or basketball.

Factors that can make you more likely to have shin splints include:

• A sudden increase in exercise intensity

• Running on hard or uneven surfaces

• Running up an incline

• Wearing running shoes that do not support your foot and ankle

• A previous leg injury

Pain in the lower legs could be down to reasons other than shin splints. Other causes include: 

• Stress fractures – tiny cracks in the bone that occur as a result of intense exercise

• A sprain or strain – these cause pain, swelling and bruising 

• Peripheral arterial disease – reduced blood supply to the legs causes an aching pain that’s triggered by activity and stops with rest

• Compartment syndrome – swelling of the leg muscle can cause cramping pain that develops gradually during activity and disappears quickly with rest. This can be serious so call 111 if you have symptoms.

How to treat shin splints

Shin splints are not serious and usually get better by themselves within a few weeks. In the meantime, avoid repetitively exercising your lower legs.

Shin splints can usually be treated at home with a few simple measures:

• Pain relief – take over-the-counter painkillers such as paracetamol or ibuprofen to help ease the pain

• Rest – this is the most important treatment. Avoid any activity that may have led to the shin splints and give your body time to heal 

• Ice – gently press an ice pack (or bag of frozen peas) on the injured part of your shins for up to 20 minutes every few hours to help reduce pain and swelling

• Switch up your activity – try low-impact activities such as swimming, yoga and cycling to minimise the pressure you put on your shins while keeping fit

Once the pain has gone, you can start to gradually increase your activity levels over the following weeks. Avoid rushing back into exercise at the level you were at previously as you risk hurting yourself permanently. 

When should I seek help?

See a healthcare professional if:

• The pain is not getting better after a week despite resting, using ice and taking painkillers

• The pain is getting worse

A healthcare professional will ask you about your symptoms and then examine your leg to rule out other causes of shin pain. They may also refer you to a physiotherapist.

If you have difficulty putting any weight on the painful leg, call 111 or consider visiting your GP practice or walk-in centre.

Advice for preventing shin splints

Your shin splints will recover with appropriate rest and treatment as described above. However, it can return if you do not look at the underlying cause of your shin splints. 

Some steps that you can take to reduce your chances of getting shin splints: 

• Warm up your muscles (especially front of your legs and calves) before exercising and stretch them after activity

• Make gradual changes to your activity level

• Try mixing high-impact activities such as running with low-impact activities such as swimming

• Ensure your trainers provide the appropriate level of support and cushioning and fit well 

• Train and run on flat, soft surfaces where possible

You may also benefit from seeing a podiatrist (foot specialist) and a physiotherapist who can help you identify ways to reduce pressure on your legs and modify your training programme.