Shin Splints

The term "shin splints" means different things to different people. In the broadest sense, it refers to any pain in the shins that flares up during exercise. The pain often comes from inflammation in the tendons, the cords that attach bone to muscle. Another common culprit: tiny stress fractures in the leg bone (tibia), which occur as the soft tissues pull away from the shin as a result of overuse.

Shin splints are a classic overuse injury, meaning they usually occur when people push their legs too hard for too long. With so many recreational runners out there, there's no shortage of potential victims. A report in Medicine and Science in Sports and Exercise found that shin splints account for up to 16 percent of all injuries in runners.

According to the report, shin splints are especially common in novice runners and, at the other end of the spectrum, competitive runners. Runners who are in poor shape or who have had previous leg injuries are also prime targets. You may also be especially susceptible if you run on hard surfaces like concrete and asphalt. And the condition doesn't bother only joggers -- other high-impact sports like basketball, soccer, tennis, and racquetball can also cause problems.

A case of shin splints isn't serious, but it can be extremely aggravating. Whether you're a casual jogger or an elite athlete, you don't want shin splints to slow you down.

What do shin splints feel like?

Many people describe shin splints as a vague, aching feeling. If you have a stress fracture, the pain may be sharp and localized. Shin splints most often occur along the inside of the shin above the ankle, or along the outside of the shin below the knee. In most cases, the problem develops gradually after a few weeks or months of intense exercise, but some people can feel the pain after one especially rigorous run. A person with shin splints usually feels pain when starting a workout. The pain may fade as the exercise continues, but it often comes back with a vengeance when a person finally rests. Many people wake up very sore the next morning.

How are shin splints treated?

The best treatment for shin splints is giving your legs a rest. You can still walk and go to work and do just about anything else, but hold off on running for two to four weeks. Over-the-counter pain medications like aspirin or ibuprofen can help ease any lingering pain. You can also try putting an ice pack on the sore spot for 20 minutes twice a day.

If the pain doesn't go away within a few weeks, schedule an appointment with your doctor. In very rare cases, surgery may be needed to relieve the pain.

How can I avoid shin splints?

As reported in Medicine and Science in Sports and Exercise, very few studies have looked at ways to prevent shin splints. In the absence of scientific evidence, runners will have to rely on good old common sense.

Clearly, being reasonable in the way you exercise is one of the best defenses against shin splints. The American Academy of Orthopaedic Surgeons recommends that you stretch and warm up for five minutes before going for a run. If you want to improve your conditioning, increase your distances gradually. As your legs get stronger, they can withstand more abuse -- although it's always good not to overdo it.

Proper shoes can save you a lot of pain. Choose a pair that provides plenty of support and cushioning. According to a report from Rice University, shoes lose 30 percent to 40 percent of their shock-absorbing ability after 500 miles of use. Even if the tread still looks fine, shoes with that much mileage should be retired. A shock-absorbent insole can be a valuable addition to any shoe.

Also, you might want to try running on a softer surface, like grass or trails, especially in the first few workouts after taking some time off to rest your legs. (Your knees will thank you, too.)

Shin splints are likely to occur when runners start to increase their mileage -- say, from one or two miles a day to three or four miles a day. It's a good idea to follow the "10 percent rule," or boosting your activity level 10 percent at a time. If you normally jog one mile, for example, begin by increasing that to one-and-one-tenth miles rather than four.

If you haven't been exercising much lately, it's only natural to want to make up for lost time. But remember: It's hard to stay in shape when your shins are screaming. Keep your goals realistic, keep your shoes in good shape, and keep your shins happy.

References

Thacker SB et al. The prevention of shin splints in sports: a systematic review of literature. Medicine and Science in Sports and Exercise.

National Institutes of Health. Medline Plus Medical Encyclopedia. Shin Splints.

American Academy of Orthopaedic Surgeons. Shin Splints.

American Academy of Orthopaedic Surgeons. Tips for a safe running program.

Rice University. Shin Splints.