Shin splints is an umbrella term used to describe pain around the shin, usually caused by weight-bearing activities like running, walking, or jumping.
Myth Buster: Shin splints does not involve bone splinting or splinters.
Despite the name, shin splints have nothing to do with actual splints or splinting of the bone (1). It’s a condition that can stem from various causes, including bone stress, nerve-related issues, muscular problems, or, less commonly, periostitis (inflammation of the tissue around the bone). The pain most often occurs along the tibia (the main shin bone) and is clinically known as Medial Tibial Stress Syndrome (MTSS).
Firstly, Bone Stress – Is It Always Bad?
Bone stress is often misunderstood as being a predominantly negative description (largely due to the word “stress”). In reality, whenever we engage in weight-bearing exercises, our bones naturally experience some level of stress. This stress, when managed properly with adequate rest, nutrition, and sleep, helps our bones recover and become stronger over time—this is how we improve bone health!
However, balance is key. Too much or too little bone stress can have negative effects.
Too Much Stress
Too much bone stress happens when we suddenly ramp up weight-bearing activities, such as starting a new running or walking routine without allowing enough time for our body to adapt and recover (or in other words, doing too much too soon). Over time, this can lead to injuries like MTSS (Shin splints).
Too Little Stress
On the other hand, insufficient activity or bone stress can result in conditions like osteopenia or osteoporosis, particularly in postmenopausal women. These conditions lead to weaker bones, which increase the risk of fractures from minor trips or falls.
Think of bone stress like a seesaw—too much on one side or too little on the other can potentially create an imbalance that negatively affects your health.
MTSS vs. Stress Fracture: What’s the Difference?
Bone stress can affect any bone, but we’ll focus on MTSS since it’s the most common form of shin pain.
MTSS occurs on the inner part of the shin bone (the tibia) and can result in pain during activities like running or jumping, impacting your ability to partake in usual sports. It’s usually tender to touch along a large portion of the bone. MTSS wouldn’t typically be seen on an X-ray (as it hasn’t caused any type of fracture yet) but may be seen on an MRI.
Signs of a Stress Fracture
Stress fractures, however, tend to be more severe. The pain is localized to a small area and can persist for a long time. If left untreated, MTSS can eventually progress into a stress fracture. A stress fracture may be seen on an X-ray (but still not always!), and almost certainly on an MRI.
How to Manage Shin Splints – 4 Key Tips
- Do Less (for Now!) While treatments like massage, pain relief, or taping might provide temporary relief, they don’t address the root cause of the issue. The first step in managing shin splints is reducing weight-bearing activities. Focus on these three areas:
- Frequency: Reduce how often you perform weight-bearing activities (e.g., avoid running on consecutive days).
- Volume: Cut down your weekly mileage by 30% (this means steps too, keep those to 70% of normal for a couple of weeks).
- Intensity: Lower the intensity of activities like sprinting, jumping, or hiking.
- Eat More! Food is your body’s fuel, and it’s crucial for recovery. Insufficient nutrition is like trying to shovel snow while it’s still snowing—it’s very difficult to make any real progress. Ensure you’re fuelling your body with adequate protein, calcium, and vitamin D to support recovery and bone health. If you’re struggling with your diet or fuelling, I always recommend reviewing your nutrient intake.
- Increase Your Cadence Cadence refers to your step count per minute. Whether you’re walking or running, try to increase your cadence by 10%. This means taking shorter, quicker steps. This simple adjustment can help disperse the forces your shins experience each time your foot hits the ground.
- Start Strength Training It’s essential to strengthen not just your shin muscles but all the muscles involved in walking or running. Stronger muscles help distribute the forces more efficiently, reducing stress on the bones and improving overall performance. While exercises like strengthening the tibialis anterior (the muscle in front of your shin) are popular at the moment, it’s important to prioritise muscles like the calf and quadriceps, which contribute more significantly to movement (2).
Here’s a quick comparison of the amount of force different muscles experience during running, and why it’s more beneficial to target certain ones, over others:
- Quadriceps: 4.89x body weight per step
- Gastrocnemius (calf): 2.97x body weight per step
- Soleus (calf): 7.34x body weight per step
- Tibialis Anterior (shin): 0.50x body weight per step
So, if you’d like to discuss your symptoms in more detail or your shin splints persist despite trying these strategies, don’t hesitate to reach out. Our experts can help you get back to doing the things you love—pain-free
References:
1. Batt ME. Shin splints–a review of terminology. Clin J Sport Med. 1995;5(1):53-7. doi: 10.1097/00042752-199501000-00010. PMID: 7614083.
2. Dorn TW, Schache AG, Pandy MG. Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance. J Exp Biol. 2012 Jun 1;215(Pt 11):1944-56. doi: 10.1242/jeb.064527. Erratum in: J Exp Biol. 2012 Jul 1;215(Pt 13):2347. PMID: 22573774.
