For many young athletes and dedicated runners, it is hard to imagine slowing down their workout and practice routines for a little ache in the shins. But Scott & White orthopedic surgeon Darryl B. Thomas, MD, said working through the pain isn’t always in your best interest.
“Doctors call it a tibial stress reaction; otherwise known as a shin splint,” Dr. Thomas said. “It happens when the amount of activity exceeds the stress level of the bone.”
When an athlete is warming up or trying out for a team and running or jumping a lot more than they ordinarily would, they begin to experience pain along the anterior border of the shin.
“It can also happen when you’re transferring from one surface to another,” he said. “If you’ve been running inside all year and then start running outside, those subtle changes in the way the muscles react can put more stress on the shins.”
The doctor said that often athletes ignore the pain and do everything they can to keep playing—taping up their shins and wearing special shoes or insoles.
“But what we worry about as doctors is that they’re over using or abusing their bone,” Dr. Thomas said. “If it continues and they ignore the warning signs, it can become a stress fracture.”
If an athlete develops a stress fracture, they could be off the field or track for up to 12 weeks while the injury heals.
Who’s at risk of developing shin splints?
“Pretty much any running or jumping athlete,” Dr. Thomas said. “Track and cross country are the ones that deal mostly with shin splints.”
But those who are most at risk, he said, are thin teenage girls.
“A lot of it has to do with the onset of their menstrual cycle and the hormonal differences they have,” he said. “If they’re in really good shape and really active athletes, then they might not be putting on the peak bone mass like other girls their age.”
Athletes who have gained weight—muscle or otherwise—are also at risk of developing shin splints.
“They’re running with more pounds of muscle or fat then they are used to, causing stress [on the shins].”
How are shin splints treated?
“Most of the time, we treat shin splints with avoidance of overuse activity,” Dr. Thomas said. “They can run or jump until it hurts or not go as far or as long.”
Generally, if the athlete avoids strenuous activity from the onset of shin pain, it will eventually go away.
“But if the [shin splints] are persisting any longer than that, then they need to be seen by either their athletic trainer, refrain from activity or see their primary care physician for a formal excuse to stay off of it so it doesn’t become a stress fracture.”
To lessen the pain of a shin splint in its early stages, Dr. Thomas suggests elevating the leg, icing the shins right over the bone and taking anti-inflammatory medication.
How do you know if it’s a shin splint or something more serious?
You often don’t know, the doctor said. It’s a clinical judgment.
“If you touch the bone and it’s tender to the touch, or if you try and bend it and you have a lot of pain, then it might be a stress fracture,” he said. “Shin splints ache, but there shouldn’t be tenderness.”
The only way to rule out a stress fracture, for someone who is experiencing chronic shin pain, is with an MRI.
Is there anything an athlete can do to prevent shin splints?
The best course of action is to stretch before you exercise, the orthopedic surgeon said.
“A lot of people, especially after being off for a season, will be stiff or they won’t be as limber as they usually are,” he said. “So, making sure that they stretch their calf muscles and their knee muscles—the two muscles that cross over the shin bone—will help decrease the risk of developing shin splints.”
The key to prevention, the doctor said, is listening to what your body is telling you.
“Note when you experience the pain during your workout and where your threshold is before it happens, so you can stop there.”
For more information about shin splints, Dr. Thomas suggests speaking with your athletic trainer or primary care physician.
Shin splints are common among runners. What other exercise pains are you dealing with during your exercise routines?