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Medial tibial stress syndrom Content Supplied by NHS Choices
Introduction

Shin splints is the term given for exercise-induced pain in the front lower legs, or shins. The medical name for it is medial tibial stress syndrome.

Shin splints come on during or after strenuous activity, particularly running or sports with sudden stops and starts, such as basketball and tennis (see below).

The pain is felt along the shin bone, called the tibia, which runs down the inner part of the shin. It is a dull pain at first, but if you ignore it and continue exercising it can become extremely painful and force you to stop sport altogether.

It is really important not to 'run through the pain', as the shin pain is a sign of injury to the bone and surrounding tissues in your leg. Continued force on the legs will make the injury and your pain worse. 

Instead, you should rest and take a break from the sport for at least two weeks. You can still exercise during this time off, but choose activities that will not put too much force on your shins, such as cycling or swimming. See Live Well: easy exercises for some ideas.

This page explains:

  • why shin splints happen
  • who is more at risk
  • how you can recover fully from shin splints and get back to your usual exercise programme
  • how to prevent it happening again
  • when you should see your GP (see box, left)

Why shin splints happen

Shin splints are brought on by intense and frequent periods of exercise that your body is not used to - for example, long-distance running. Sports that involve sudden stopping and starting, such as basketball or tennis, can also put you at risk.

This activity puts pounding pressure on your legs, especially if you are exercising on hard ground, and causes injury to the bone and surrounding tissues.

Experts do not fully understand the nature of the injury, but it is possible that small tears develop in the membrane between the two leg bones, or that tiny fractures form in the surface of the shin bone.

People who are more at risk

You are more at risk of shin splints if you:

  • have been running for less than five years
  • are running on hard surfaces or slopes
  • wear poorly fitting or worn-out trainers that do not support the foot properly
  • are overweight, as this places extra weight on your legs
  • have flat feet or feet that tend to roll inwards, as this places more pressure on the lower leg
  • have weak ankles or a tight Achilles tendon (band of tissue connecting the heel bone to the calf muscle)

Rest and recovery

You should be able to recover fully from shin splints if you rest for at least two weeks. This means you should not do any running or 'stop and start' sports during this time, although walking, swimming and cycling are OK.

Pain and any swelling can be relieved by raising your leg and holding an ice pack to your shin (try a bag of frozen peas wrapped in a tea towel). Do this for 10 minutes every few hours for the first two days.

Over-the-counter painkillers, such as ibuprofen or paracetamol, may also help.

Getting back to your usual exercise programme

You can return to your usual activity after at least two weeks of rest, and only when the pain has gone. Increase your activity level slowly, gradually building up the time you spend running or doing sports.

It is also important that you warm up and stretch before you start exercising (see Live Well: fitness training tips for more information). If the pain returns, stop immediately.

A sports physiotherapist will be able to advise you on a suitable graded running programme. You can ask your GP for a referral on the NHS or arrange an appointment yourself privately with a physiotherapist or doctor specialising in sport and exercise medicine. Search for a sports medicine physiotherapist 

Preventing the pain returning

You can avoid shin splints in future by:

  • getting fitted for supportive running shoes (see Live Well - choosing sports shoes)
  • using shock-absorbing insoles or (if you have flat feet) insoles to support the foot better - these can be bought from a pharmacy or online
  • avoid training on hard surfaces if possible
  • build up your activity level gradually 


 
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