What’s Shin Splint Pain All About?

Too much, too fast – that’s typically what leads to sharp pain in your shins.

What you may not know is shin splints have more to do with your hip, ankle or foot muscles not being strong enough to handle the increased exercise.

Anyone who’s had them can attest to the pain that shin splints bring.

So can it be stopped?

“There’s a discussion in orthopedics on shin splints – do you fix them from the top down, by strengthening the hip muscles, or do you work from the arch of the foot up to them and work on stronger ankles and feet?” said Jonathan Buchanan, MD, Avera Orthopedics. “Both sides have merit. But one approach that will not work is just trying to ‘run through’ the pain.”

What Are Shin Splints?

Simple soreness is something that most have felt after exercise. Shin splints are a level up from it, but a level below stress fractures. They are a common exercise-related issue that refers to pain along the inner edge of the tibia due to inflammation.

They are most often associated with running and typically occur when the leg is overworked or from sudden changes in activity, such as increasing frequency, intensity or duration of running. It can also be caused when your tibialis anterior is compensating for lack of arch strength.

Worn out shoes or flat feet can be other causes. If shin pain occurs and you haven’t replaced your shoes in awhile that could be an easy fix.

Otherwise, the next step is to moderate your level of activity and work on strengthening exercises.

“Adjust your distance to steer clear of the pain, because the pain isn’t ‘good’ or making you a better runner, football player or track star,” he said. “It’s just a sign that you’re going too far.”

Shin Splints vs. Stress Fracture

While some shin splint pain may be from running too hard, too soon, the pain should subside after you’re done with practice or a workout. If the pain in your shin bone lingers or if it’s quite intense and wakes you up at night – it may be a stress fracture.

“If it hurts all day, and that pain remains, it’s more than likely a stress fracture and you should get in to see your doctor,” he said. “Shin splints represent stress at the point where muscles pull on the bone. Stress fractures are serious injuries. If it lingers, it’s indicating something significant – you may have deep pain, down near the bone, and that’s more likely to be a stress fracture,” he said.

Read more about stress fractures.

Exercises and Stretches for Shin Splint Pain and Prevention

To avoid them, you’ll need to cross-train,

and strengthen the intrinsic foot muscles, ankles and hips. A trainer can provide more personal guidance. Examples include:

• Toe curls
• Single leg glute bridges
• Step-ups
• Hip abduction or side-lying leg lifts
• Ankle exercises using resistance bands

“The tension in your shins is like a bow,” Buchanan said. "When it’s pulled back, there’s tension as well as compression on the various areas of the wood. When you’re running or working out, you’re doing the same thing to the muscles and bones of that part of your body. Too much can lead to pain.”

There’s no certain stretch that can keep shin splints away, because they develop from the weakness in the hips or ankles. When those muscles cannot hold things together in the front of your lower leg, micro-tears along the bone-and-muscle connection form and lead to pain. Treatment may include rest and ice, but if it’s severe, it could require more attention.

Physical therapy could be an option to help with strengthening issues. If the pain persists a consultation for a possible stress fracture may be recommended.

“The best tip is to dial back on running and refocus,” Buchanan said. “If that doesn’t make a difference then we’ll create a plan from there.”