Shin splints, also called “Medial Tibial Stress Syndrome,” (MTSS) is caused when the muscles of your lower leg pull too hard on your bone, causing local pain and inflammation. Over half of all leg pain in athletes is caused from shin splints. Up to 1/3 of runners and soldiers experience shin splints at some point in their lifetime.

MTSS is an overuse injury frequently seen in sports involving running, jumping, or frequent stopping & starting, i.e. field hockey, soccer and cross-country. Shin splints do not occur overnight but over a period of time, often show up during the first two or three weeks of training for a new season. Shin splints can occur when there are changes to your exercise regimen, such as an increase in activity, change in shoes or a change in the surface you play on. Some doctors refer to these training areas as “the terrible toos,” – too much, too hard, too long, too fast.

Symptoms of shin splints include tenderness or pain over the inside lower portion of your shin. The discomfort begins at the start of exercise and eases as you continue. Some patients report “bumps” when touching the inner portion of their leg bone. Be sure to tell your doctor if you experience weakness, numbness or cold feet during exercise or find a very small area of sensitivity.

Unfortunately, MTSS usually develops during a time when you are training heavily for a sport or an upcoming event. Continuing this activity will often lead to ongoing problems and decreased performance. Shin splints are now believed to be a forerunner to stress fracture, so adequate rest is critical. You may need to consider non-weight bearing cross training, such as using a stationary cycle or pool running.

When directed, your return to activity should start slowly, beginning with a 1/4 mile run and progressing by 1/4 mile each time you have no pain for two consecutive workouts. You should initially avoid running on hard or uneven surfaces and begin at a lower intensity and distance, increasing by no more than 10-15% per week- first increase distance, then pace, and avoid hard or unlevel surfaces, including hills.

Sports creams and home ice massage may provide some relief. Use ice after any activity. Patients who have flat feet are predisposed to developing shin splints and may need arch supports or orthotics. Avoid using heel cushions in your shoes, as they may increase the recurrence of this problem.