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Shin Splints in Sports


Dr. Les Dutko, Ed.D, LAT, ATC


Shin splints are most often referred to any lower leg pain mostly involving the bones tibia or fibula and the soft tissue of the lower leg.  However, this is very misleading since this pain may be the result of other more serious injuries.  Shin splints can be classified into two areas that pain occurs; to the front of the lower leg along the shin bone, the tibia called anterior shin splints.  Conversely, pain that occurs on the back inside of the lower leg is labeled posterior medial shin splints.

Shin splints generally occur after cumulative stress, daily stress which causes micro trauma to the soleus muscle at the point of attachment to the shinbone or tibia.  Continued stress can also cause pain and irritation of the posterior tibialis muscle and inflammation of the periosteum, which is the connect tissue that covers the tibia.


Shin splints are almost always the results of overuse, or overloading the soft tissues, and not allowing proper conditioning or enough recovery time between practices.  The majority of athletes who develop shin splints will describe a protocol of an exercise history that includes sudden increases in intensity, or duration of impact practices combined with a lack of proper rest between practices.  The latter eventually leads to muscle trauma and if not corrected to bone trauma or stress fracture.

Muscle trauma also labeled exertional compartment syndrome is most often related to overtraining or running on hard surfaces day in and day out.  This repeated use results in the muscles swelling and puts pressure on the fascia that covers the muscles in the lower leg progressing to pressure and pain.  This condition left unchecked may cause microscopic cracks and advances to bone trauma to the lower leg which eventually leads to stress fractures of the tibia and fibula.  Rest is needed to repair these cracks, without adequate recover, these cracks continue to grow and become a stress fracture.  The result is acute pain along with night pain and a long recovery.


  1. Improper stretching
  2. Lack of warm-up
  3. Training too hard
  4. Lack of rest between training bouts
  5. Increasing mileage too quickly
  6. Jumping or running on hard surfaces
  7. Muscle imbalance between the posterior and anterior leg
  8. Worn out shoes that do not have enough support
  9. Running on a tilted or slanted surface
  10. Other biomechanical issues, such as pronation


  1. Pain located on the medial or inside part of the lower leg
  2. Pain is often worse with running or other weight bearing activities
  3. Pain increases after running on hard surfaces
  4. An aching pain may linger after stopping activity
  5. Pain increases with running, jumping, hill climbing, or downhill running
  6. Calf muscles may be tight and inflexible


  1. Rest is the best treatment for shin splints
  2. R.I.C.E. to control pain and inflammation
  3. Returning to play gradually with non-weight activities, cycling and swimming.
  4. Strengthening and stretching via ankle injury rehab protocol
  5. Tape your shins to reduce stress
  6. Wear proper footwear
  7. Replace shoes as needed

*Returning to activity must be done gradually:

The best way to accomplish this is to adjust your exercise regimen by reducing the duration and intensity so that you have no discomfort before, during, and after exercise.

  • If your shin pain continues after three of more weeks, you should seriously consider seeing your physician for a proper diagnosis!!!

Duke University School of Medicine. May, 2006



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