Causes of Shin Splints

The term “shin splints” is given for pain felt anywhere along the shinbone at the front of your leg and can be caused by inflammation or overload of muscles, tendons, and/or bone tissue in these areas.

Shin Splint Symptoms

Medial Tibial Stress Syndrome (MTSS)

What is it?

MTSS is a painful condition common amongst running athletes.  The most recent evidence suggests that MTSS involves a non-inflammatory, bone-stress reaction caused by repetitive loads that cause bending forces of the shin-bone.  Essentially, it is the shin-bone’s reaction to too-much load in too-little time!

What are the symptoms?

  • Tenderness to touch
  • Pain in this area on the early stages of exercise that dissipates as you warm-up, only to come back during the cool-down period (called the “warm-up effect”)
  • Pain in the hours or days following aggravating activity
  • Pain in this area upon waking

Bone Stress Injuries of the tibia (shinbone)

What is it?

Often the result unmanaged or misdiagnosed MTSS, bone stress injuries can be a complication of shin pain associated with running and loading.  A bony stress reaction occurs when there is a repetitive, chronic overload of the shin bone that is not given the opportunity to rest and restore balance, causing a stress reaction (inflammation) of the bone structure under load.

Persistence through a bone stress reaction can lead to a bone stress fracture – a debilitating yet very avoidable consequence of poor shin-pain management.

What are the symptoms?

  • Localised, deep, nagging ache pain at the front of the shin
  • Tenderness when area of pain is touched
  • Constant pain during exercise
  • Worst during impact activities (i.e. during running, jumping)
  • Aching at night or rest

Compartment Syndrome

What is it?

Chronic Exertional Compartment Syndrome (CECS) is a condition that presents as exercise-induced pain in the calf or shin that can be mistaken for shin-splints.

When exercising, more blood is sent from the heart to the peripheries – particularly to the legs – causing muscles to ‘swell’.  This can cause a build-up of pressure in the legs, resulting in compression of the small blood vessels and a presentation of pain.  When exercise is ceased (or the intensity is reduced), this pain slowly diminishes.

What are the symptoms?

Feeling of tightness / mild pressure in the legs during exercise (usually on the outer front edge of the shin)
Mild swelling of the affected area(s)
Aching, tight, cramping or squeezing pain
Paraesthesia (altered nerve sensations, such as numbness or pins and needles)
Pain that reduces after rest or a reduction in exercise intensity

How long will it take to get better?

Please note the below timeframes are a ball-park figure only, and differ depending on each person.

Medial Tibial Stress Syndrome: 2-6 weeks of relative rest

The amount of activity that is appropriate during this stage is best guided by your Trained Physio, they will ensure no de-conditioning occurs whilst ensuring the amount of exercise does not aggravate the condition.

During and after this period of relative rest, your Trained Physio will guide your return to full activity whilst addressing any biomechanics or strength factors that are contributing to the development of MTSS.

Low-grade Bone Stress Injuries: 12-14 weeks

High-grade bone stress injuries: ~24 weeks

How can Trained Physio help my shin splints?

There are many factors that often contribute to the development of MTSS, and it is important to identify and address these factors sooner rather than later.  Usually, the development of MTSS is secondary to underlying biomechanical, strength, or range issues (it can also be a combination of all three!) Did you know at Trained Physio we have a fully equipped rehabilitation facility?  Check out the details here.  Physiotherapy has several goals including promote healing, reduce pain, avoiding aggravation, optimising physical function and global strengthening to restore normal movement patterns.  To see how we can help you BOOK ONLINE TODAY