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MusculoskeletalICD-10: M76.89Accounts for up to 13-17% of all running-related injuries

Shin Splints (Medial Tibial Stress Syndrome)

Shin splints, medically known as medial tibial stress syndrome, is a common exercise-related condition that causes pain along the inner edge of the shinbone (tibia). The condition results from repeated stress on the tibia and the connective tissues that attach muscles to the bone. Shin splints are one of the most frequent causes of leg pain in runners, dancers, and military recruits.

Symptoms

Dull, aching pain along the front or inner part of the lower leg
Tenderness and soreness along the shinbone
Mild swelling in the lower leg
Pain that worsens during and after exercise
Pain that initially improves with rest but returns with activity
Numbness or weakness in the feet in severe cases

Causes

  • Overuse from sudden increases in exercise intensity, frequency, or duration
  • Repetitive impact on hard surfaces during running or jumping
  • Biomechanical abnormalities such as flat feet (overpronation) or high arches
  • Worn-out or improper athletic footwear lacking adequate support

Risk Factors

  • Beginning a new exercise program or dramatically increasing training volume
  • Running on hard or uneven surfaces
  • Flat feet, high arches, or rigid arches
  • Military training or activities involving prolonged marching
  • Previous history of shin splints or stress fractures
  • Female sex (higher incidence in female athletes)

Diagnosis

  • Physical examination assessing tenderness along the medial tibial border
  • X-rays to rule out stress fractures
  • Bone scan or MRI for persistent cases to differentiate from stress fractures
  • Gait analysis to evaluate biomechanical factors

Treatment

  • Rest and activity modification to allow healing
  • Ice application for 15-20 minutes several times daily
  • Over-the-counter pain relievers (ibuprofen, naproxen) for pain and inflammation
  • Compression bandages to reduce swelling
  • Physical therapy with stretching and strengthening exercises for the lower leg
  • Custom orthotics or arch supports to correct biomechanical issues

Prevention

  • Gradually increase exercise intensity using the 10% rule
  • Wear properly fitted, supportive athletic shoes and replace them regularly
  • Cross-train with low-impact activities such as swimming or cycling
  • Strengthen calf, hip, and core muscles to improve lower limb stability
  • Run on soft, even surfaces when possible
  • Warm up thoroughly before exercise and stretch afterward

When to See a Doctor

  • Shin pain does not improve with rest and home treatment after 2-3 weeks
  • The area is visibly swollen, red, or feels hot to the touch
  • Pain occurs even at rest or during normal walking

Frequently Asked Questions

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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