I see it all of the time. It might be a runner who is trying to increase mileage or someone who is trying to get back into shape so he/she has recently picked up running after a long absence. Shin splints are a common running injury, but they can also be seen in active individuals such as those in the military and first responder populations. This type of injury is a nagging type that only worsens the further you push through it. It tends to get better with rest but rears its ugly head every time you return to the aggravating activity.
Shin splints exercises can help prevent and ease many of these episodes of shin pain, but understanding the causes of shin splints is also important to help prevent this type of injury in the first place. By the end of this article, you will have gained a great understanding of these causes and you will know exactly which shin splints exercises to do to treat this debilitating injury.
Table of Contents
What are Shin Splints?
Shin splints (formally known as Medial Tibial Stress Syndrome) is an overuse injury that is commonly seen in active individuals who are exposed to repetitive impacts such as running and jumping. In fact, studies have shown that shin splints affect up to 20% of runners and 35% of military recruits! Individuals suffering from shin splints will notice a gradual worsening of shin pain that increases the longer that the person is exposed to the aggravating activity. This is different than other common foot and ankle injuries such as Achilles Tendonitis, pain in the back of the ankle, and Ankle Sprains, pain on the inside or outside of the ankle, as shin splints cause pain along the front side of the shin bone in the lower leg.
Symptoms caused by shin splints are typically reported as a constant dull, ache that can progress into a sharp pain that eases with rest. This condition is considered self-limiting as the longer that someone continues to perform the activity, the worse the pain gets, and eventually, the individual will have to stop performing the activity altogether.
Causes of Shin Splints
Overuse injury of the muscles that are located on either side of the Tibia bone (lower leg bone).
Bone stress reaction in the outside layer of fascia that surrounds the Tibia bone in the lower leg.
Common Training Mistakes
Deconditioning
- Starting a new training program should be done cautiously and gradually to allow our muscles, tendons, and bones time to adapt to the new stresses
Sudden increase in the frequency, duration, or frequency of training
- Recommend increasing running distance by only 10% each week
Improper running shoes or worn-out shoes
- Changing shoes can be problematic if there has been a significant change in the type of shoe (i.e. changing from a traditional mid to high-drop shoe to a zero-drop).
Running or training on uneven terrain (i.e. hills) or hard surfaces (i.e. concrete, pavement)
- Training on uneven or hard surfaces increases the joint reaction forces that the lower leg has to absorb
Having flat feet or high arches
- Flat feet and excessively high arches reduce the body’s natural ability to disperse stress forces from the ground up throughout the lower leg
How to Diagnose Shin Splints?
The individual will complain of pain originating near the shin that increases with impact activities and decreases with rest. There will be tenderness to touch at the site near the Tibia. Your doctor may order additional tests to rule out other possible injuries.
Other Possible Leg Injuries that Can Be Mistaken as Shin Splints
Tibial Stress Fracture
- If a person continues to train while having shin splints, it is possible for the Tibial stress reaction to progress into a full-blown stress fracture. An X-ray, MRI, or bone scan would be required to determine the severity of the stress fracture.
Chronic Exertional Compartment Syndrome
- Exertional compartment syndrome occurs in rare cases, but it does create pain similar to shin splints. It is caused by increased pressure inside the lower leg compartment between the Tibia and Fibula and it causes the lower leg to have a hard “woody” feel to it during exercise that reduces with rest.
Shin Splints Treatment Options
Rest
- Stop performing the aggravating activities and switch to non-impact activities temporarily to maintain cardiovascular endurance (i.e. rowing, elliptical, cycling)
Ice
- Ice the lower leg for 10-15 mins to help relieve pain and inflammation
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Anti-Inflammatory Medications
- Over-the-counter medications such as Ibuprofen (Advil), Naproxen (Aleve), or acetaminophen (Tylenol) can help relieve inflammation and pain. Be sure to check with your doctor before consuming any medications to make sure it is safe for you to take.
Shin Splints Exercises
- Perform my shin splints exercises daily to treat and prevent any future onsets of shin splints pain
Physical Therapy
- If you can’t get a handle on your shin pain with my shin splints exercises alone, you may require one-on-one care with your physical therapist to get specialized care
Additional Imaging
- X-rays, MRIs, and bone scans can help to rule out the presence of any progressive injuries such as a stress fracture
Training Prevention Tips
› Gradually increase training frequency, duration, and intensity
- Gradually increase training dosage (Recommend increasing running distance by only 10% each week)
› Use a supportive running shoe
- Finding a trusted running shoe company is a MUST! I routinely recommend my patients check out both Brooks Running Shoes and HOKA Running Shoes as they both have excellent, supportive running shoes.
› Replace stock running shoe insoles with after-market insoles
- The insoles that come standard in a running shoe are completely worthless. Have you ever pulled one of them out? They are flimsy and cheap. If you are experiencing shin splints or maybe you’re just trying to prevent getting shin splints, then you’ll definitely want to upgrade your insoles. I always recommend Superfeet insoles to my friends and patients alike and I use them in all of my hiking boots and running shoes. Superfeet makes some of the best after-market insoles out there.
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The BEST Shin Splints Exercises for Pain Relief!
Massage the Shin Muscles
- Massage the Tibialis Anterior and Tibialis Posterior Muscles
- Gently massage the muscles on either side. of the Tibia bone to reduce tightness and tenderness.
- Perform: 3-5 minutes per day
Foam Rolling
- Use this: OPTP Pro-Roller Foam Roll
- Foam roll the inside and outside of the lower leg.
- Look for areas of tightness and tenderness.
- Perform: 3-5 minutes per day (especially after sports)
Tibialis Anterior Stretch
- Sit with one leg crossed over.
- Grab the top of the foot while blocking the ankle with the other hand.
- Gently pull the toes and top of the foot down and in until a stretch is felt on the top of the foot and front of the ankle.
- Perform: 30 seconds x 3 sets
Ankle Inversion with Band
- Use this: Theraband Flat Resistance Band
- Perform: 3 sets x 10-15 reps
Ankle Eversion with Band
- Use this: Theraband Flat Resistance Band
- Perform: 3 sets x 10-15 reps
Ankle Dorsiflexion with Band
- Use this: Theraband Flat Resistance Band
- Perform: 3 sets x 10-15 reps
Single Leg Stance with External Band Pulls
- Use this: Theraband Flat Resistance Band
- Stand on one leg, keep a bent elbow tucked into your side, pull the band while rotating the hand away from belly button. Repeat.
- Perform: 3 sets x 10-15 reps
Single Leg Stance with Internal Band Pulls
- Use this: Theraband Flat Resistance Band
- Stand on one leg, keep a bent elbow tucked into your side, pull the band while rotating the hand toward the belly button. Repeat.
- Perform: 3 sets x 10-15 reps
Seated Ankle Dorsiflexion with Weight
- Use this: Bowflex SelectTech 840 Adjustable Kettlebell
- Perform: 3 sets x 10-15 reps
Dual Heel Raise with Tennis Ball
- Place a tennis ball, lacrosse ball, or similar object between your heels.
- This motion isolates the Tibialis Posterior muscle.
- Actively squeeze the ball while simultaneously performing a heel raise on both feet.
- Perform: 3 sets x 10-15 reps
