How to treat shin splits

Sports Injuries Guidebook

Common causes

Shin splints and medial tibial stress syndrome (a more severe form of shin splints) are caused by an inflammation of the periosteal sleeve of tissue surrounding the tibia. This type of injury frequently occurs in running or other repetitive cardiovascular activities in which the athlete suddenly increases the distance, duration, or frequency of a training regimen. The muscular insertion of the tibialis anterior, tibialis posterior, and soleus are frequently affected.

Symptoms typically include a burning or aching pain on the medial (nearer the middle of the body) aspect of the leg or shin after completion of the activity. This pain is a common complaint among runners who are training for a marathon or young athletes who are conditioning at the outset of a new sporting season. The area of pain and tenderness usually spreads out over an area of three-fingers width along the front or back edge of the shinbone. X-rays are usually normal but bone scan reveals localized uptake along the edge of the bone.


Treatment for shin splints involves a change in the athlete’s training regimen (e.g., decreased mileage, frequency, or intensity of exercise). Icing of the involved area after activity helps in the short term. If pain persists, or gets worse, despite curtailing the level of activity, the athlete should seek professional attention to rule out a more serious injury such as a stress fracture or exertional compartment syndrome. Examine the athlete’s footwear and feet for additional problems. Look for excessive and uneven wear on the soles of running shoes, which may represent biomechanical flaws. Also, if the athlete’s feet pronate excessively (the arch flattens as the foot strikes the ground under load), an orthotic may be indicated.

Return to action

Typically, a one- to two-week layoff from impact exercise allows for a rapid return. A return is recommended when the athlete can practice comfortably and is pain free after vigorous exercise. Taping is seldom useful in achieving a quicker recovery from shin splints.