Shin Splints


Shin splints are a common injury characterized by pain along the inside or outside of the shin bone (tibia). The medical term for pain along the inside of the tibia is periostiitis (inflammation of the periosteum) or posterior tibialis tendonitis (inflammation of the posterior tibialis tendon). The periosteum is a sheath of tissue that connects the muscles of the calf to the tibia. The posterior tibialis is a muscle that runs along the tibia deep to the calf muscles and attaches to the inside aspect of the foot and is partially responsible for maintaining the arch of the foot. The medical term for pain along the outside or front of the tibia is called anterior tibialis tendonitis (inflammation of the anterior tibialis tendon). The anterior tiablis is a muscle that runs along the front of the tibia and takes the majority of the stress when your heel strikes the ground if you are a heel runner.

Shin splints are usually caused by over use or repetitive stress and are most common among runners. Typically, shin splints will develop when runners increase their mileage or intensity too quickly, or when runners don’t allow for enough recovery time between intense workouts. The connective tissues attaching to the tibia become inflamed causing pain and can sideline the runner for weeks or even months.


Shin splints should be treated conservatively with rest and ice to reduce the inflammation.


Physical therapy is effective in treating shin splints by using ultrasound and massage to increase circulation and promote healing. As the pain decreases, stretches and light resistance exercises may be introduced to the affected muscles.  As the healing progresses the exercises should also progress with greater resistance to restore the strength of the affected muscles, and cardiovascular exercises should progress from biking to an elliptical trainer in preparation for the return to running.

A chronic condition of shin splints may be the result of a bio-mechanical imbalance, such as flat feet or poor running technique. A bio-mechanical imbalance can cause an increased stress to the muscles of the calf, which can result in overuse and an eventual breakdown of the tissue. Be sure that you are running in the proper running shoe for your foot type. If your running shoe is not providing you with enough support, you may benefit from a pair of custom foot orthotics, which would help to correct your foot mechanics and reduce unnecessary stress to the muscles of the calf.


A video running analysis can help you determine if your running technique is a contributing factor to your shin splints. Heel running is the most likely cause of anterior tibialis tendonitis. Heel running is an inefficient form of running and places all of the impact stress on the anterior tibialis muscle. It is more efficient to land on the mid-foot or forefoot to allow the calf muscles to absorb the impact.

Of course, the best treatment is prevention. Take the time to build up a good base of running before adding too much intensity or volume. Always allow for proper recovery between intense workouts and after long workouts. And remember, a week of rest can often save you three months of frustration.