Our knowledge of orthopaedics. Your best health.

Shin splint pain most often occurs on the inside edge of your tibia (shinbone).

Reproduced and adapted with permission from Gruel CR: Lower Leg, in Sullivan JA, Anderson SJ (eds): Care of the Young Athlete. Rosemont, IL, American Academy of Orthopaedic Surgeon, 2000.

Shin splints (medial tibial stress syndrome) is an inflammation of the muscles, tendons, and bone tissue around your tibia. Pain typically occurs along the inner border of the tibia, where muscles attach to the bone.

In general, shin splints develop when the muscle and bone tissue (periosteum) in the leg become overworked by repetitive activity.

Shin splints often occur after sudden changes in physical activity. These can be:

• Changes in frequency, such as increasing the number of days you exercise each week
• Changes in duration, such as running longer distances
• Changes in intensity, such as running on hills after running on only flat surfaces

Other factors that contribute to shin splints include:

• Having flat feet or abnormally rigid arches
• Exercising with improper or worn-out footwear

Runners have the highest risk of developing shin splints. Dancers and military recruits are two other groups frequently diagnosed with the condition.

Flat feet can increase stress on lower leg muscles during exercise.

The most common symptom of shin splints is pain along the border of the tibia. Mild swelling in the area may also occur.

Shin splint pain may:

• Be sharp and razor-like or dull and throbbing
• Occur both during and after exercise
• Be aggravated by touching the sore spot

After discussing your symptoms and medical history, your doctor will examine your lower leg. An accurate diagnosis is very important. Sometimes, other problems may exist that can have an impact on healing.

Your doctor may order additional imaging tests to rule out other shin problems. Several conditions can cause shin pain, including:

• Stress fractures
• Tendinitis
• Chronic exertional compartment syndrome

Your doctor will examine your lower leg, checking for pain and tenderness along the inner border of the tibia (shinbone).

There are things you can do to prevent shin splints.

Wear a proper fitting athletic shoe. To get the right fit, determine the shape of your foot using the "wet test." Step out of the shower onto a surface that will show your footprint, like a brown paper bag.

• If you have a flat foot, you will see an impression of your whole foot on the paper.
• If you have a high arch, you will only see the ball and heel of your foot.

When shopping, look for athletic shoes that match your particular foot pattern. In addition, make sure you wear shoes designed for your sport. Running long distances in court-type sneakers can contribute to shin splints. Learn more: Athletic Shoes

Cross train. Alternate jogging with lower impact sports like swimming or cycling.Learn more: Cross Training

Barefoot running. Many people claim barefoot running has helped to resolve shin splints. Some research indicates that it spreads out impact stresses among muscles, so that no area is overloaded. However, there is no clear evidence that barefoot running reduces the risk of any injury. Learn more: Is Barefoot Running Better?

Like any significant change in your fitness regimen, a barefoot running program should be started very gradually. Begin with short distances to give your muscles and your feet time to adjust. Pushing too far, too fast can put you at risk for stress injuries.

In addition, barefoot runners are at increased risk for cuts and bruises on their feet. Several brands of minimalist shoes with "toes" are available and these also require a slow working in period as your body adjusts to this different activity.

If your shin splints do not improve after rest and other methods described above, see a doctor to determine whether something else is causing your leg pain.