Shin Splints

What are Shin Splints

Shin splints is a painful condition that is felt either on the bone that is located in the front of the lower leg (tibia or shin bone) or in the muscles on either side of the bone. This condition happens when physical activities lead to inflammation of the muscles, tendons, and the thin layer of tissue that covers the shin bone. It may result from participating in sports or other intense exercise.

What are the causes?

This condition may be caused by:

  • Overuse of muscles.
  • Repetitive activities.
  • Flat feet or rigid arches.

Activities that could contribute to shin splints include:

  • Having a sudden increase in exercise time.
  • Starting a new, intense activity.
  • Running up hills or long distances.
  • Playing sports that involve sudden starts and stops.
  • Not warming up before activity.
  • Wearing old or worn-out shoes.

What are the signs or symptoms?

The main symptom of this condition is pain that occurs:

  • On the front of the lower leg.
  • In the muscles on either side of the shin bone.
  • While exercising or at rest.

How is this diagnosed?

This condition may be diagnosed based on:

  • A physical exam.
  • Your symptoms.
  • An observation of you while you are walking or running.
  • X-rays or other imaging tests. These may be done to rule out other problems.

How is this treated?

Treatment for this condition depends on your age, history, overall health, and how bad the pain is. Most cases of shin splints can be managed by doing one or more of the following:

  • Resting.
  • Reducing the length and intensity of your exercise.
  • Stopping the activity that causes shin pain.
  • Taking medicines to control the inflammation.
  • Icing, massaging, stretching, and strengthening the affected area.
  • Wearing shoes that have rigid heels, shock absorption, and a good arch support.

For severe shin pain, your health care provider may recommend that you use crutches to avoid putting weight on your legs.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not drive or use heavy machinery while taking prescription pain medicine.

Managing pain, stiffness, and swelling

  • If directed, apply ice to the painful area. Icing can help to relieve pain and swelling.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • If directed, apply heat to the painful area before stretching exercises, or as told by your health care provider. Heat can help to relax your muscles. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
    • Place a towel between your skin and the heat source.
    • Leave the heat on for 20–30 minutes.
    • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.
  • Massage, stretch, and strengthen the affected area as directed by your health care provider.
  • Wear compression sleeves or socks as told by your health care provider.
  • Raise (elevate) your legs above the level of your heart while you are sitting or lying down.

Activity

  • Rest as needed. Return to activity gradually as told by your health care provider.
  • When you start exercising again, begin with non–weight-bearing exercises, such as cycling or swimming.
  • Stop running if the pain returns.
  • Warm up properly before exercising.
  • Run on a surface that is level and fairly firm.
  • Gradually change the intensity of an exercise.
  • If you increase your running distance, add only 5–10% to your distance each week. This means that if you are running 5 miles this week, you should only increase your run by ¼–½ mile for next week.

General instructions

  • Wear shoes that have rigid heels, shock absorption, and a good arch support.
  • Change your athletic shoes every 6 months, or every 350–450 miles.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms continue, or they worsen even after treatment.
  • The location, intensity, or type of pain changes over time.
  • You have swelling in your lower leg that gets worse.
  • Your shin becomes red and feels warm.

Get help right away if:

  • You have severe pain.
  • You have trouble walking.

Summary

  • Shin splints happens when physical activities lead to inflammation of the muscles, tendons, and the thin layer of tissue that covers the shin bone.
  • Treatments may include medicines, resting, and icing.
  • Return to activity gradually as directed by your health care provider.
  • Make sure you know what symptoms should cause you to contact your health care provider.

Shin Splints Rehabilitation

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercise

This exercise warms up your muscles and joints and improves the movement and flexibility of your lower leg. This exercise also helps to relieve pain, numbness, and tingling.

Exercise A: Calf stretch, standing

  1. Stand with the ball of your left / right foot on a step. The ball of your foot is on the walking surface, right under your toes.
  2. Keep your other foot firmly on the same step.
  3. Hold onto the wall, a railing, or a chair for balance.
  4. Slowly lift your other foot, allowing your body weight to press your left / right heel down over the edge of the step. You should feel a stretch in your left / right calf.
  5. Hold this position for __________ seconds.
  6. Repeat this exercise with a slight bend in your left / right knee.

Repeat __________ times with your left / right knee straight and __________ times with your left / right knee bent. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your lower leg. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise B: Dorsiflexion

  1. Secure a rubber exercise band or tubing to a fixed object, such as a table leg or a pole.
  2. Secure the other end of the band around your left / right foot.
  3. Sit on the floor, facing the fixed object. The band should be slightly tense when your foot is relaxed.
  4. Slowly use your ankle muscles to pull your foot toward you.
  5. Hold this position for __________ seconds.
  6. Slowly release the tension in the band and return your foot to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: Ankle eversion with band

  1. Secure one end of a rubber exercise band or tubing to a fixed object, such as a table leg or a pole, that will stay in place when the band is pulled.
  2. Loop the other end of the band around the middle of your left / right foot.
  3. Sit on the floor, facing the fixed object. The band should be slightly tense when your foot is relaxed.
  4. Make fists with your hands and put them between your knees. This will focus your strengthening at your ankle.
  5. Leading with your little toe, slowly push your banded foot outward, away from your other leg. Make sure the band is positioned to resist the entire motion.
  6. Hold this position for __________ seconds.
  7. Control the tension in the band as you slowly return your foot to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Ankle inversion with band

  1. Secure one end of a rubber exercise band or tubing to a fixed object, such as a table leg or a pole, that will stay still when the band is pulled.
  2. Loop the other end of the band around your left / right foot, just below your toes.
  3. Sit on the floor, facing the fixed object. The band should be slightly tense when your foot is relaxed.
  4. Make fists with your hands and put them between your knees. This will focus your strengthening at your ankle.
  5. Leading with your big toe, slowly pull your banded foot inward, toward your other leg. Make sure the band is positioned to resist the entire motion.
  6. Hold this position for __________ seconds.
  7. Control the tension in the band as you slowly return your foot to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Lateral walking with band

  1. Stand in a long hallway.
  2. Wrap a loop of exercise band around your legs, just above your knees.
  3. Bend your knees gently and drop your hips down and back so your weight is over your heels.
  4. Step to the side to move down the length of the hallway, keeping your toes pointed forward and keeping tension in the band.
  5. Repeat, leading with your other leg.

Repeat __________ times. Complete this exercise __________ times a day.

Balance exercise

This exercise will help improve your control of your foot and ankle when you are standing or walking.

Exercise F: Single leg stand

  1. Without wearing shoes, stand near a railing or in a doorway. You may hold onto the railing or door frame as needed.
  2. Stand on your left / right foot. Keep your big toe down on the floor and try to keep your arch lifted.
  3. If this exercise is too easy, you can try doing it with your eyes closed or while standing on a pillow.
  4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

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