Shin splints

The term shin splints refers to pain in the shins (the lower part of the leg just above the ankle and below the knee). The medical terminology for this condition is medial tibial stress syndrome. Keep in mind that many other conditions can cause pain in the lower legs besides shin splints.


Causes/associated factors
Although medical opinions often differ, shin splints are generally believed to be caused by inflammation of the tissues in the lower leg, including the muscles, tendons (the tissue that connects muscles to bones) and periosteum (the membrane that covers the bones). These tissues may become inflamed when you begin exercising or do something strenuous after a period of inactivity. Sometimes, shin splints develop when your usual activity becomes too stressful. This can occur as a result of improper technique during running or jumping or with a change in running surface or terrain. In other cases, people have anatomic abnormalities that make them more likely to get shin splints. Improper equipment (shoes, for example) may contribute to the problem as well.

Signs/symptoms
Shin splints usually cause pain along the bone called the tibia at the front of the leg, typically around the middle or lower third of the bone (toward your ankle). Sometimes, shin splints can also be characterized by pain elsewhere around the tibia. You may also notice swelling.

Diagnosis
The doctor will review your medical history, ask questions about your symptoms and do a physical exam. You may need an X-ray, bone scan or magnetic resonance imaging (MRI, an imaging technique based on computer analysis of the body's response to a magnetic field) to rule out conditions with similar symptoms, such as a stress fracture (small cracks in a bone caused by repetitive overuse). If needed, your doctor may order other tests based on your symptoms.

Treatment
The doctor may recommend stopping all activity at first, and then slowly resuming your normal routine once you're free of pain. While you're recovering, it may help to apply ice to the affected area. For pain and inflammation, a nonsteroidal anti-inflammatory medication such as ibuprofen may be recommended. Finally, your doctor may prescribe an orthotic (a specially made shoe insert designed to decrease stress on your lower leg). Complete recovery may take anywhere from two weeks to four months.

Complications
Left untreated, shin splints may progress to a stress fracture of the tibia.

Pregnancy-specific information
Pregnancy is not a risk factor for shin splints.

Senior-specific information
Growing older is not a risk factor for shin splints.

Prevention
Making permanent changes in your physical activity is the key to preventing recurrent shin splints. Here are some tips.
Wear shoes that fit well and have good arch support.
Work into an exercise routine slowly after periods of inactivity.
Stretch your leg muscles before and after exercising.
Exercise on soft, even surfaces. Try the ground instead of pavement, for example.
Decrease the intensity or duration of aerobic exercise.