415:. Cross training (e.g., cycling, swimming, boxing) is recommended in order to maintain aerobic fitness. Individuals should return to activity gradually, beginning with a short and low intensity level. Over multiple weeks, they can slowly work up to normal activity level. It is important to decrease activity level if any pain returns. Individuals should consider running on other surfaces besides asphalt, such as grass, to decrease the amount of force the lower leg must absorb.
53:
340:
302:
shock absorption properly, forcing the tibia to absorb most of the impact. Lack of cushioning footwear, especially on hard surfaces, does not absorb transmitting forces while running or jumping. This stress is associated with the onset of shin splints. Muscle imbalance, including weak core muscles, inflexibility and tightness of lower leg muscles, including the
330:
of the tibia where it inserts into the bone. With repetitive stress, the impact forces eccentrically fatigue the soleus and create repeated tibial bending or bowing, contributing to shin splints. The impact is made worse by running uphill, downhill, on uneven terrain, or on hard surfaces. Improper
402:
Treatments include rest, ice, and gradually returning to activity. Rest and ice help the tibia to recover from sudden, high levels of stress and reduce inflammation and pain levels. It is important to reduce significantly any pain or swelling before returning to activity. Strengthening exercises
301:
While the exact mechanism is unknown, shin splints can be attributed to the overloading of the lower leg due to biomechanical irregularities resulting in an increase in stress exerted on the tibia. A sudden increase in intensity or frequency in activity level fatigues muscles too quickly to help
185:) due to inflammation of tissue in the area. Generally this is between the middle of the lower leg and the ankle. The pain may be dull or sharp, and is generally brought on by high-impact exercise that overloads the tibia. It generally resolves during periods of rest. Complications may include
361:
On physical examination, gentle pressure over the tibia will recreate the type of pain experienced. Generally more than a 5 cm length of tibia is involved. Swelling, redness, or poor pulses in addition to the symptoms of shin splints indicate a different underlying cause.
456:
is one of the massage techniques that may be useful. A technique such as deep transverse friction to relieve muscle tightness will help stop the build-up of scar tissue. This can overall release tension in the calf muscle area, relieving pressure that is causing pain.
228:
Shin splint pain is described as a recurring dull ache, sometimes becoming an intense pain, along the inner part of the lower two-thirds of the tibia. The pain increases during exercise, and some individuals experience swelling in the pain area. In contrast,
219:
may help some people. Surgery is rarely required, but may be done if other measures are not effective. Rates of shin splints in at-risk groups range from 4% to 35%. The condition occurs more often in women. It was first described in 1958.
1528:
824:
Bennett, Jason E.; Reinking, Mark F.; Pluemer, Bridget; Pentel, Adam; Seaton, Marcus; Killian, Clyde (2001). "Factors
Contributing to the Development of Medial Tibial Stress Syndrome in High School Runners".
421:
and insoles help to offset biomechanical irregularities, like pronation, and help to support the arch of the foot. Other conservative interventions include improving form during exercise, footwear refitting,
1153:
196:. Groups that are commonly affected include runners, dancers, gymnasts, and military personnel. The underlying mechanism is not entirely clear. Diagnosis is generally based on the symptoms, with
1323:
Rompe, Jan D.; Cacchio, Angelo; Furia, John P.; Maffulli, Nicola (2010). "Low-Energy
Extracorporeal Shock Wave Therapy as a Treatment for Medial Tibial Stress Syndrome".
1606:
464:(ESWT) and surgery. Surgery does not guarantee 100% recovery, and is only performed in extreme cases where non-surgical options have been tried for at least a year.
696:
Tweed, J.L.; Avil, S.J.; Campbell, J.A.; Barnes, M.R. (2008). "Etiologic factors in the development of medial tibial stress syndrome: A review of the literature".
1189:
236:
Women are several times more likely to progress to stress fractures from shin splints. This is due in part to women having a higher incidence of diminished
731:
Edwards, Peter H.; Wright, Michelle L.; Hartman, Jodi F. (2005). "A Practical
Approach for the Differential Diagnosis of Chronic Leg Pain in the Athlete".
1145:
1599:
1280:
Loudon, Janice K.; Dolphino, Martin R. (2010). "Use of Foot
Orthoses and Calf Stretching for Individuals with Medial Tibial Stress Syndrome".
17:
781:
Yates, B.; White, S. (2004). "The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits".
1965:
1592:
203:
Shin splints are generally treated by rest followed by a gradual return to exercise over a period of weeks. Other measures such as
669:
Carr, K.; Sevetson, E.; Aukerman, D. (2008). "Clinical inquiries. How can you help athletes prevent and treat shin splints?".
358:. The important factors on history are the location of pain, what triggers the pain, and the absence of cramping or numbness.
1007:"An Anatomical and Physiological Evaluation of the Periosteal Layer Surrounding Bone and Its Implication in Massage Therapy"
655:
383:
1462:"Incidence of trauma related stress fractures and shin splints in male and female army recruits: retrospective case study"
204:
1366:
Yates, Ben; Allen, Mike J.; Barnes, Mike R. (2003). "Outcome of
Surgical Treatment of Medial Tibial Stress Syndrome".
959:
Moen, MH; Tol, JL; Weir, A; Steunebrink, M; De Winter, TC (2009). "Medial tibial stress syndrome: a critical review".
1794:
318:) can increase the possibility of shin splints. The pain associated with shin splints is caused from a disruption of
1841:
461:
1220:
860:
Haycock, Christine E.; Gillette, Joan V. (1976). "Susceptibility of women athletes to injury. Myths vs reality".
139:
1006:
1403:"Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis"
1237:
Couture, Christopher (2002). "Tibial Stress
Injuries: Decisive Diagnosis and Treatment of 'Shin Splints'".
394:(MRI) may be performed. Bone scans and MRI can differentiate between stress fractures and shin splints.
391:
431:
1960:
408:
1543:
343:
513:
282:
Engaging the anti-pronatory (supinating) muscles in excessive amounts of eccentric muscle activity
1930:
1925:
1698:
1584:
315:
91:
472:
Rates of shin splints in at-risk groups are 4% to 35%. Women are affected more often than men.
126:
1745:
276:
1804:
375:
355:
303:
46:
Medial tibial stress syndrome (MTSS), soleus syndrome, tibial stress syndrome, periostitis
8:
1692:
1666:
453:
319:
286:
212:
899:
1702:
1688:
1661:
1437:
1402:
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1305:
1262:
1212:
1167:
1121:
1088:
1057:
1032:
984:
806:
756:
607:
81:
256:. Groups that are commonly affected include runners, dancers, and military personnel.
1881:
1835:
1615:
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1383:
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1340:
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113:
69:
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968:
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869:
834:
790:
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591:
379:
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208:
1767:
1627:
1548:
412:
230:
197:
186:
131:
119:
96:
74:
838:
639:
293:
People who have previously had shin splints are more likely to have them again.
1831:
1718:
1048:
427:
1537:
1104:
595:
1954:
1799:
1428:
1336:
1293:
1112:
794:
744:
460:
Less-common forms of treatment for more-severe cases of shin splints include
435:
350:
showing high signal (bright) areas around the tibia as signs of shin splints.
347:
307:
1477:
1250:
1740:
1708:
1572:
1446:
1387:
1344:
1301:
1258:
1208:
1130:
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938:
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802:
752:
717:
682:
651:
603:
241:
237:
216:
1495:
1401:
Newman, Phil; Witchalls, Jeremy; Waddington, Gordon; Adams, Roger (2013).
1619:
1419:
881:
331:
footwear, including worn-out shoes, can also contribute to shin splints.
103:
1520:
52:
1649:
1567:
404:
327:
270:
135:
582:
Reshef, N; Guelich, DR (April 2012). "Medial tibial stress syndrome".
1917:
1873:
1781:
1713:
1680:
447:
439:
423:
387:
263:
154:
1459:
709:
1869:
1676:
1640:
418:
1614:
1732:
443:
339:
311:
1860:
1855:
1623:
1532:
1089:"Medial tibial stress syndrome: conservative treatment options"
323:
1400:
898:. University of Michigan Health. Retrieved 26 June 2021, from
1895:
1819:
1759:
1728:
1635:
1460:
Macleod MA, Houston AS, Sanders L, Anagnostopoulos C (1999).
182:
61:
1168:"Shin Splints Symptoms, Treatment, Recovery, and Prevention"
823:
1913:
1823:
1777:
1653:
1146:"Running 101: How To Select The Best Pair Of Running Shoes"
1087:
Galbraith, R. Michael; Lavallee, Mark E. (7 October 2009).
64:. Pain is generally in the inner and lower 2/3rds of tibia.
1033:"Medial Tibial Stress Syndrome: Evidence-Based Prevention"
275:
Excessively tight calf muscles (which can cause excessive
1891:
1755:
1322:
1190:"Stress fractures: diagnosis, treatment, and prevention"
354:
Shin splints are generally diagnosed from a history and
695:
27:
Inflammation of the inner edge of the shin bone (tibia)
1368:
The
Journal of Bone and Joint Surgery. American Volume
1011:
Journal of the
Australian Traditional-Medicine Society
958:
900:
https://www.uofmhealth.org/health-library/tp23004spec
776:
774:
772:
770:
698:
Journal of the
American Podiatric Medical Association
386:. If the cause is unclear, medical imaging such as a
1510:
1026:
1024:
827:
730:
668:
1188:Patel, Deepak S.; Roth, Matt; Kapil, Neha (2011).
767:
259:Risk factors for developing shin splints include:
1086:
1021:
817:
289:surfaces (such as running on asphalt or concrete)
181:, is pain along the inside edge of the shinbone (
1952:
1365:
1000:
998:
403:should be performed after pain has subsided, on
917:Medicine & Science in Sports & Exercise
859:
1279:
1187:
913:"Exercise-related lower leg pain: An overview"
252:Shin splints typically occur due to excessive
192:Shin splints typically occur due to excessive
1600:
1004:
995:
581:
1082:
1080:
1078:
1076:
1093:Current Reviews in Musculoskeletal Medicine
954:
952:
950:
948:
862:Journal of the American Medical Association
285:Undertaking high-impact exercises on hard,
1607:
1593:
1183:
1181:
780:
633:
631:
629:
627:
625:
623:
621:
577:
575:
573:
571:
569:
567:
565:
563:
561:
559:
557:
555:
520:. American Academy of Orthopaedic Surgeons
86:Pain along the inside edge of the shinbone
51:
1485:
1436:
1418:
1160:
1120:
1073:
1056:
928:
637:
553:
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365:
945:
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501:
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495:
493:
491:
489:
487:
485:
338:
233:pain is localized to the fracture site.
200:done to rule out other possible causes.
1325:The American Journal of Sports Medicine
1236:
1178:
1156:from the original on 13 September 2014.
910:
733:The American Journal of Sports Medicine
618:
14:
1953:
1407:Open Access Journal of Sports Medicine
532:
1588:
1144:Lobby, Mackenzie (9 September 2014).
1143:
1030:
894:Healthwise Staff. (7 December 2020).
511:
482:
223:
384:popliteal artery entrapment syndrome
205:nonsteroidal anti-inflammatory drugs
149:Rest with gradual return to exercise
108:Runners, dancers, military personnel
783:American Journal of Sports Medicine
658:from the original on 29 March 2023.
638:McClure, CJ; Oh, R (January 2019).
24:
296:
25:
1977:
1966:Dislocations, sprains and strains
1795:Anterior cruciate ligament injury
1506:
512:Alaia, Michael J. (August 2019).
1380:10.2106/00004623-200310000-00017
1239:The Physician and Sportsmedicine
973:10.2165/00007256-200939070-00002
961:Sports Medicine (Auckland, N.Z.)
930:10.1249/00005768-200003001-00001
874:10.1001/jama.1976.03270020033020
462:extracorporeal shockwave therapy
1453:
1394:
1359:
1316:
1273:
1230:
1137:
1005:De Permentier, Patrick (2014).
904:
888:
640:"Medial Tibial Stress Syndrome"
467:
370:Other potential causes include
322:that connect the medial soleus
140:exertional compartment syndrome
853:
724:
689:
671:The Journal of Family Practice
662:
13:
1:
475:
179:medial tibial stress syndrome
18:Medial tibial stress syndrome
1037:Journal of Athletic Training
397:
334:
7:
1282:Foot & Ankle Specialist
839:10.2519/jospt.2001.31.9.504
10:
1982:
1049:10.4085/1062-6050-43.3.316
584:Clinics in Sports Medicine
392:magnetic resonance imaging
167:4% to 35% (at-risk groups)
1912:
1890:
1868:
1854:
1818:
1776:
1754:
1727:
1675:
1648:
1634:
1558:
1514:
1197:American Family Physician
1105:10.1007/s12178-009-9055-6
1031:Craig, Debbie I. (2008).
596:10.1016/j.csm.2011.09.008
247:
163:
153:
145:
125:
112:
102:
90:
80:
68:
59:
50:
42:
37:
1337:10.1177/0363546509343804
1294:10.1177/1938640009355659
795:10.1177/0095399703258776
745:10.1177/0363546505278305
346:of the lower leg in the
344:Magnetic resonance image
60:Red area represents the
1931:Achilles tendon rupture
1926:Patellar tendon rupture
1478:10.1136/bmj.318.7175.29
1251:10.3810/psm.2002.06.337
911:Brukner, Peter (2000).
316:flexor digitorum longus
366:Differential diagnosis
351:
314:muscles (commonly the
207:(NSAIDs), cold packs,
127:Differential diagnosis
342:
1805:Patellar dislocation
1420:10.2147/OAJSM.S39331
1226:on 12 February 2019.
376:compartment syndrome
356:physical examination
1693:Dislocated shoulder
454:Deep tissue massage
118:Based on symptoms,
1746:Gamekeeper's thumb
1703:Separated shoulder
1662:Dislocation of jaw
1559:External resources
923:(3 Suppl): S1–S3.
352:
224:Signs and symptoms
1948:
1947:
1944:
1943:
1882:Rotator cuff tear
1850:
1849:
1836:High ankle sprain
1582:
1581:
1374:(10): 1974–1980.
450:supplementation.
254:physical activity
194:physical activity
171:
170:
114:Diagnostic method
32:Medical condition
16:(Redirected from
1973:
1961:Overuse injuries
1904:Pulled hamstring
1866:
1865:
1810:Knee dislocation
1790:Tear of meniscus
1646:
1645:
1609:
1602:
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1219:. Archived from
1194:
1185:
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1158:
1157:
1141:
1135:
1134:
1124:
1084:
1071:
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1028:
1019:
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1002:
993:
992:
956:
943:
942:
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896:Low bone density
892:
886:
885:
857:
851:
850:
821:
815:
814:
778:
765:
764:
739:(8): 1241–1249.
728:
722:
721:
693:
687:
686:
666:
660:
659:
635:
616:
615:
579:
530:
529:
527:
525:
509:
442:injections, and
432:balance training
380:nerve entrapment
372:stress fractures
320:Sharpey's fibres
209:physical therapy
187:stress fractures
177:, also known as
55:
35:
34:
21:
1981:
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1908:
1886:
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1768:Hip dislocation
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1723:
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1630:
1613:
1583:
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1509:
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1321:
1317:
1278:
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1235:
1231:
1223:
1192:
1186:
1179:
1166:
1165:
1161:
1142:
1138:
1085:
1074:
1029:
1022:
1003:
996:
957:
946:
909:
905:
893:
889:
858:
854:
822:
818:
779:
768:
729:
725:
710:10.7547/0980436
694:
690:
667:
663:
636:
619:
580:
533:
523:
521:
510:
483:
478:
470:
434:(e.g., using a
400:
368:
337:
299:
297:Pathophysiology
266:or rigid arches
250:
231:stress fracture
226:
198:medical imaging
132:Stress fracture
120:medical imaging
97:Stress fracture
75:Sports medicine
33:
28:
23:
22:
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12:
11:
5:
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1832:Sprained ankle
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1719:Bankart lesion
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1515:Classification
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1507:External links
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1358:
1331:(1): 125–132.
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1150:Competitor.com
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1099:(3): 127–133.
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1043:(3): 316–318.
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994:
967:(7): 523–546.
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887:
868:(2): 163–165.
852:
833:(9): 504–510.
816:
789:(3): 772–780.
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723:
704:(2): 107–111.
688:
677:(6): 406–408.
661:
644:NCBI Bookshelf
617:
590:(2): 273–290.
531:
514:"Shin Splints"
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428:manual therapy
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1800:Unhappy triad
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436:balance board
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304:gastrocnemius
294:
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287:non-compliant
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92:Complications
89:
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76:
73:
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67:
63:
58:
54:
49:
45:
41:
36:
30:
19:
1936:Shin splints
1935:
1741:Pulled elbow
1709:ALPSA lesion
1620:subluxations
1616:Dislocations
1573:Shin splints
1566:
1542:
1527:
1472:(7175): 29.
1469:
1465:
1455:
1410:
1406:
1396:
1371:
1367:
1361:
1328:
1324:
1318:
1288:(1): 15–20.
1285:
1281:
1275:
1245:(6): 29–36.
1242:
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1221:the original
1203:(1): 39–46.
1200:
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522:. Retrieved
517:
471:
468:Epidemiology
459:
452:
417:
401:
369:
360:
353:
326:through the
300:
292:
258:
251:
242:osteoporosis
238:bone density
235:
227:
217:Shoe insoles
202:
191:
178:
174:
172:
104:Risk factors
38:Shin splints
29:
1413:: 229–241.
524:15 November
213:compression
175:shin splint
43:Other names
1955:Categories
1568:Patient UK
1017:: 272–277.
476:References
409:quadriceps
328:periosteum
271:overweight
136:tendinitis
1874:upper arm
1714:SLAP tear
1681:upper arm
1641:ligaments
1429:1179-1543
1113:1935-973X
612:262469440
518:OrthoInfo
448:vitamin D
440:cortisone
424:orthotics
398:Treatment
388:bone scan
335:Diagnosis
277:pronation
264:Flat feet
164:Frequency
155:Prognosis
146:Treatment
70:Specialty
1870:Shoulder
1842:Turf toe
1677:Shoulder
1667:Whiplash
1447:24379729
1388:14563807
1353:21114701
1345:19776340
1302:20400435
1267:39133382
1259:20086529
1209:21888126
1154:Archived
1131:19809896
1067:18523568
989:40720414
981:19530750
939:10730988
847:11570734
811:24603853
803:15090396
753:16061959
718:18347118
683:18544325
656:Archived
652:30860714
604:22341017
419:Orthoses
413:gluteals
82:Symptoms
1861:tendons
1856:Muscles
1733:forearm
1628:strains
1624:sprains
1549:D058923
1496:9872880
1438:3873798
1310:3374384
1217:1736230
1122:2848339
1058:2386425
761:7828716
444:calcium
312:plantar
1636:Joints
1494:
1484:
1445:
1435:
1427:
1386:
1351:
1343:
1308:
1300:
1265:
1257:
1215:
1207:
1129:
1119:
1111:
1065:
1055:
987:
979:
937:
882:947011
880:
845:
809:
801:
759:
751:
716:
681:
650:
610:
602:
405:calves
382:, and
324:fascia
310:, and
308:soleus
269:Being
248:Causes
211:, and
1896:thigh
1820:Ankle
1760:thigh
1729:Elbow
1538:M79.6
1487:27673
1349:S2CID
1306:S2CID
1263:S2CID
1224:(PDF)
1213:S2CID
1193:(PDF)
1172:WebMD
985:S2CID
807:S2CID
757:S2CID
608:S2CID
183:tibia
62:tibia
1916:and
1914:Knee
1894:and
1872:and
1824:foot
1822:and
1780:and
1778:Knee
1758:and
1731:and
1679:and
1654:neck
1652:and
1650:Head
1626:and
1544:MeSH
1492:PMID
1443:PMID
1425:ISSN
1384:PMID
1341:PMID
1298:PMID
1255:PMID
1205:PMID
1127:PMID
1109:ISSN
1063:PMID
977:PMID
935:PMID
878:PMID
843:PMID
799:PMID
749:PMID
714:PMID
679:PMID
648:PMID
600:PMID
526:2020
446:and
411:and
240:and
159:Good
1918:leg
1892:Hip
1858:and
1782:leg
1756:Hip
1638:and
1529:ICD
1482:PMC
1474:doi
1470:318
1466:BMJ
1433:PMC
1415:doi
1376:doi
1333:doi
1290:doi
1247:doi
1117:PMC
1101:doi
1053:PMC
1045:doi
969:doi
925:doi
870:doi
866:236
835:doi
791:doi
741:doi
706:doi
592:doi
438:),
390:or
1957::
1699:AC
1689:GH
1622:,
1571::
1547::
1536::
1533:10
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279:)
20:)
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