Causes of shin splints explained by Sundial physio James Masterson

Jewel runs Brighton Marathon
Jewel runs Brighton Marathon

Shin splints is a common sports injury in runners and sports people but it is often mis-diagnosed and poorly treated. If left untreated shin splints can cause ongoing and progressive pain and disability sometimes requiring surgery to correct. Here Sundial physio James Masterson sheds some light on this painful condition.

Shin splints was a medical term used to describe pain along the middle border of the shin bone (tibia) commonly experienced by runners. However, the term shin splints can be misleading and is generally avoided by clinicians as there can be a number of reasons why a person may experience pain in their shins. Some of the most common and more specific medical terms used for shin splints are medial tibial stress syndrome (MTSS), medial tibial periostitis and medial tibial traction periostitis. This exertional lower leg injury usually develops in people who take part in repetitive activities and sports such as running.

Other reasons for lower leg pain on exertion could be:

  • Stress fractures occur when muscles become fatigued and can’t absorb repeated shock, they transfer the stress to their bony attachment which can then result in a small crack or fracture of the bone.
  • Compartment syndrome is a painful condition where pressure of the muscles in the lower leg builds within their confined compartments. When this pressure increases it causes a decrease in blood flow which prevents nourishment and oxygen reaching the nerves and muscle cells.

Cause shin splints

Why does Shin Splints happen?

Shin splints or Medial Tibial Stress Syndrome (MTSS) occurs during physical activity and results from too much force being placed on the thin layer of connective tissue (periosteum) which covers the shin bone (tibia) and attaches the bone to the muscle tendon. The muscles which may contribute to this problem are the ones in the calf and inner side of the tibia. These muscles flex the big toe and push the ball of the foot down. These work hard every time you take step and even harder when you run.


Common problems which lead to Shin Splints (MTSS):

Recent increase in exercise intensity or duration.
• Biomechanical irregularities i.e. poor posture and problematic walking or running pattern such as over-pronation.
• Inflexibility and tightness of muscles.
• Change in exercise terrain i.e. running on hard surfaces or up and down hills.
• Muscular fatigue.
• Wearing the wrong type of footwear.

What are the symptoms of Shin Splints?

MTSS pain is often described as a recurring dull ache in the middle two thirds of the shin bone (tibia). Pain is worse in the mornings and after exercise, although the pain may often decrease or disappear altogether during a warm up or beginning period of exercise. Climbing stairs or weight bearing can aggravate symptoms and muscle tightness, thickening and lumps can be felt along the area of pain. Swelling may also be present and the individual can normally locate the exact site of where pain exists.

Next article: How to treat Shin Splints