The Truth About Shin Splints: A Comprehensive Guide for Coaches, Athletes, and Physical Therapists

By Jay Cherok, PT, DPT, Cert. MSKUS

Runner using foam rolling for tissue mobility

As a physical therapist, athlete, and coach, I’ve seen many young runners confused by shin splints. This common issue can frustrate athletes and perplex coaches trying to help their teams. In this guide, I will clarify what shin splints are, how they develop, the common causes, and, most importantly, how to prevent them effectively.

What are Shin Splints?

Shin splints, medically termed medial tibial stress syndrome (MTSS), refer to pain along the shinbone (tibia), occurring mostly in runners and athletes involved in high-impact sports. The pain usually appears along the inner side of the lower leg, where muscles, tendons, and bone tissue come together. Rather than a single injury, shin splints encompass a range of symptoms resulting from repetitive stress on these structures. According to a study from the American Academy of Orthopaedic Surgeons, around 13% to 20% of runners experience shin splints at least once in their careers.

How Do Shin Splints Form?

Shin splints arise from excessive force and continuous stress on the shinbone and its surrounding tissues. These forces can cause inflammation, leading to pain and discomfort. Understanding how shin splints form is vital for effective prevention and treatment.

Common factors that contribute to shin splints include:

• Overuse: Rapidly increasing training intensity or mileage can overload the muscles and bones. For instance, increasing weekly mileage more than 10% can significantly raise injury risk.

  
  

• Improper Footwear: Running in shoes that lack proper cushioning or support can place excessive stress on the lower legs. A 2021 study found that running shoes with inadequate arch support increased the likelihood of shin splints by 30%.

  
  

• Flat Feet: Athletes with flat feet may face greater risk due to altered gait mechanics. A 2018 study showed that individuals with flat feet have a 24% higher risk of developing shin splints compared to those with normal arches.

  
  

• Hard Surfaces: Training on hard surfaces like concrete can increase the impact forces experienced by the legs.

  
  

Common Causes of Shin Splints

Several factors can lead to the development of shin splints:

• Training Errors: Many athletes often ramp up their training too quickly. A gradual increase of 10% per week in mileage or intensity is key to preventing injury.

  
  

• Muscle Imbalances: Weakness or tightness in muscle groups, such as the calves, hamstrings, or quadriceps, can contribute to the symptoms. For instance, a 2017 survey indicated that over 60% of runners with shin splints exhibited tight calf muscles.

  
  

• Biomechanical Issues: Abnormalities like overpronation (inward foot rolling) or supination (outward rolling) can cause poor alignment and extra stress on the shin.

  
  

• Lack of Flexibility: Reduced flexibility in the calf, hamstrings, and hip muscles may generate additional tension on the shin during high-impact activities. Stretching programs have shown to decrease injury rates by up to 25%.

  
  

Prevention Strategies

Prevention is key. A blend of strategies tailored to each athlete’s needs is essential. Here are some actionable recommendations for each training phase:

Pre-Season

1. Gradual Build-Up: Start training with low-impact activities like swimming or cycling. This builds cardiovascular endurance without stressing the shins.

   
   

2. Strength Training: Introduce exercises targeting the calves, quadriceps, hamstrings, and core. Resistance training, such as calf raises and toe taps, can enhance muscle endurance.

   
   

Mid-Season

1. Cross-Training: Utilize low-impact activities, such as swimming or using an elliptical, to maintain fitness while minimizing stress on the legs.

   
   

2. Flexibility Routines: Include dynamic stretching and foam rolling sessions to maintain muscle elasticity and reduce tightness.

   
   

3. Rest and Recovery: Encourage athletes to listen to their bodies. If any discomfort arises, a few days of rest can prevent further complications.

   
   

Post-Season

1. Active Recovery: Engage in low-impact options like yoga or swimming. This encourages recovery without putting stress on the body.

   
   

2. Biomechanical Assessments: Contact a Physical Therapist for a thorough assessment to identify and correct mechanical issues that may arise throughout the season.

   
   

3. Gradual Transition: After the season, maintain fitness levels with reduced, yet sustained, training to allow the body to recover.

   
   

Immediate Steps for Surging Symptoms

If any athlete begins to experience symptoms of shin splints, here are steps to take right away:

1. Rest: Halting training is crucial. Allow time for inflammation to subside.

   
   

2. Ice Therapy: Apply ice packs to the affected area for 15-20 minutes multiple times a day to alleviate pain and swelling.

   
   

3. Modify Training: Switch to low-impact activities, such as swimming or cycling, that do not aggravate the pain.

   
   

4. Consultation: Seeking help from a Physical Therapist for tailored rehabilitation is advisable.

   
   

Moving Forward with Knowledge

Understanding shin splints is crucial for coaches, athletes, and parents of young athletes. With the right knowledge about causes and preventive measures, we can significantly reduce the number of athletes affected by this condition. As both a coach and a physical therapist, I urge everyone to implement prevention strategies early; our goal is to nurture athletes who can perform their best without interruptions from shin splints or other injuries for that matter. As a coach, we need to hold ourselves accountable for the health of our athletes and ensure our training program is not the cause of the injury.

Equipping athletes with this knowledge allows them to manage their health better and enables coaches to create supportive training environments. Together, we can tackle the myths surrounding shin splints and pave the way for informed training practices.