A blog by runners. For runners.

Shin splints treatment and prevention


Shin splints are a common — and frustrating — running injury. In this post, Dr. Nace explains what causes shin splints in runners and what you can do to prevent them. 

What are shin splints?

Shin splints is a common term we often hear in the running community. It refers to the pain you feel in the shinbone (tibia), which is the front of the lower part of your leg. The medical term for shin splints is tibia stress syndrome. It occurs when too much force is put on the tibia, causing the tendons to become inflamed and ultimately, pain to develop.

Shin splints pain can range from a mild ache to more moderate to borderline intense. Sometimes you only feel it during or after a run, and other times it becomes more chronic and can be felt even at rest.

What causes shin splints?

Shin splints usually develop in runners if they ramp up their training regimen too quickly or if they become too repetitive in their running patterns. They can also occur if a change in running terrain is made, such as with the addition of more hill training. Other times shin splits are associated with improper arch support.

How do I treat shin splints?

When patients come to me with shin pain, I first use an X-ray to see if any types of fractures have occurred. If I detect a non-displaced fracture, that is usually a bad sign. It means normal weight-bearing walking and running activities will need to be shut down, and the leg must be immobilized and crutches utilized. Sometimes, in worst cause scenarios, the fracture won’t heal, which can lead to the need for more complex treatment.

If there is no fracture, I’ll then order an MRI to see if there is inflammation. While inflammation in itself isn’t a great sign, the good news is that the treatment is relatively straightforward (albeit not usually embraced since it involves less running and high-impact activities).

Most of the time, the inflammation will dissipate with activity/training modification, including a less intense workout routine. Sometimes we’ll also treat it with anti-inflammatory medications and physical therapy. You’ll know when you are good to go when your affected leg feels as flexible and pain free as your unaffected leg.

How do I prevent shin splints?

The thing about shin splints is they are unpredictable: You get them once and then never get them again or you could have them occur more frequently.

There are, however, some things you can do to help reduce the chance of occurrence:

  1. As you train, slowly ramp up your training. Add too much, too quickly and you might find yourself in pain.
  2. Wear shoes with good arch support. Whether you have flat feet or not, good arch support is essential.
  3. Run on a rubberized track or grass instead of exclusively on hard surfaces.
  4. Stretch before and after your run.
  5. If you feel pain, don’ t push it. Modify your training routine and seek out a specialist if it persists.

Related articles:

Written by Dr. James Nace, M.D.: James Nace, MD is an orthopedic surgeon-joint replacement and doctor of general orthopedics specializing in hip, knee and shoulder joint preservation and reconstruction. He practices out of the Rubin Institute for Advanced Orthopedics at Sinai Hospital of Baltimore, Maryland. Throughout his career as a physical therapist and orthopedic surgeon, Nace has gained the most satisfaction from treating runners and all types of athletes for their injuries and helping get them back to training and competing.