Learn more about shin splints: introduction
Shin splints is the name for pain in the shins, or the front of the lower legs, usually caused by exercise.
They're common in people who do a lot of running or other activities that involve repeatedly putting weight on the legs, such as tennis or basketball.
They aren't usually serious, but can stop you from exercising and may get worse if you ignore them. It's important not to run through the pain.
They can usually be treated at home and should start to get better within a few weeks.
Symptoms of shin splints
The main symptom of shin splints is pain in the shin bones, which run down the front of your lower legs.
The pain tends to:
- begin soon after starting exercise
- gradually improve when resting – sometimes the pain may fade while you're still exercising, but it can eventually become constant and continue even when resting
- be dull and achy to begin with, but may become increasingly sharp or severe and stop you exercising
- affect both shins
- be felt over a large part of the shin (an area over 5cm across) – pain in a small area may be caused by a stress fracture instead
Sometimes there may also be some swelling.
Causes of shin splints
It's not always clear what causes shin splints.
They're usually brought on by running or repetitive weight bearing on the legs. It's thought this leads to swelling (inflammation) of the tissue around the shin bone.
Several things can increase your chances of getting shin splints, including:
- a sudden change in your activity level – such as starting a new exercise plan or suddenly increasing the distance or pace you run
- running on hard or uneven surfaces
- wearing poorly fitting or worn-out trainers that don't cushion and support your feet properly
- being overweight
- having flat feet or feet that roll inwards (known as over-pronation)
- having tight calf muscles, weak ankles, or a tight Achilles tendon (the band of tissue connecting the heel to the calf muscle)
Treating shin splints at home
Shin splints can usually be treated at home. The following may help relieve the pain and allow your legs to heal:
- rest – stop the activity that causes your shin splints for at least two to three weeks; you can then start gradually returning to your normal activities
- ice – hold an ice pack against your shins (a bag of frozen peas wrapped in a tea towel works, too) for around 10 minutes every few hours for the first few days; this helps with pain and swelling
- pain relief – take over-the-counter painkillers, such as paracetamol and ibuprofen, to help relieve the pain if you need to
- switch to low-impact activities – using a cross-trainer, cycling, swimming and yoga are good ways to keep fit without putting too much pressure on your shins while they heal
You can start to return to your usual activities over the following few weeks once the pain has gone. Take care to increase your activity level gradually, building up the time you spend running or doing sports.
Make sure you follow the steps to prevent shin splints outlined below to reduce the risk of the pain coming back.
When to see your GP
It's a good idea to see your GP if your pain doesn't improve despite the treatments mentioned above.
Your GP may:
- ask about your symptoms and examine your legs to try to work out what's causing your pain
- refer you for an X-ray or special scan of your legs – an X-ray may be normal, so a more detailed scan may be needed to help with diagnosis or identify other causes of lower leg pain
- refer you to a physiotherapist – they can assess your injury, show you some exercises, and recommend a suitable programme of activity
- refer you to an orthopaedic surgeon or a consultant in sport and exercise medicine
Preventing shin splints
The following measures may help reduce your chances of getting shin splints:
- wear trainers with appropriate cushioning and support – it may help to speak to an expert at a specialist running shop for advice if you're buying running shoes for the first time
- run and train on flat, soft surfaces, such as a recreation ground or playing field, whenever possible
- introduce any changes to your activity level gradually
- mix high-impact exercises like running with low-impact exercises like swimming
- lose weight if you're overweight
- improve your overall strength and flexibility
- warm up before exercising and stretch after exercising – in particular, stretching your calves and the front of your legs may help
Speak to a foot specialist called a podiatrist if you have flat feet or your feet roll inwards. They may recommend supportive inserts for your shoes (orthotics) to reduce the pressure on your shins.
Other causes of lower leg pain
Pain in the lower legs and shins can also be caused by:
- stress fractures (tiny cracks in the bone) – the pain often affects one leg, but can affect both, and is usually focused in a small area; there may also be some swelling
- a sprain or strain – this can cause swelling, bruising and pain that continues during rest
- a tendon injury – symptoms include pain, stiffness, weakness and a grating or crackling sensation when moving the affected area
- reduced blood supply to the legs (peripheral arterial disease) – this causes an aching pain triggered by physical activity that fades after a few minutes of rest
- swelling of the leg muscle (compartment syndrome) – this can cause cramping pain in the muscles that develops gradually during exercise and fades quickly at rest
Learn more about shin splints: treatment
Sprains and strains are common injuries affecting the muscles and ligaments. Most can be treated at home without seeing a GP.
Check if you have a sprain or strain
It's likely to be a sprain or strain if:
- you have pain, tenderness or weakness – often around your ankle, foot, wrist, thumb, knee, leg or back
- the injured area is swollen or bruised
- you can't put weight on the injury or use it normally
- you have muscle spasms or cramping – where your muscles painfully tighten on their own
Is it a sprain or a strain?
|Torn or twisted ligament (tissue that connects the joints)||Overstretched or torn muscle (also known as a pulled muscle)|
|Most common in: wrists, ankles, thumbs, knees||Most common in: knees, feet, legs, back|
How to treat sprains and strains yourself
For the first couple of days, follow the 4 steps known as RICE therapy to help bring down swelling and support the injury:
- Rest – stop any exercise or activities and try not to put any weight on the injury.
- Ice – apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel) to the injury for up to 20 minutes every 2 to 3 hours.
- Compression – wrap a bandage around the injury to support it.
- Elevate – keep it raised on a pillow as much as possible.
To help prevent swelling, try to avoid heat – such as hot baths and heat packs – alcohol and massages for the first couple of days.
When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle doesn't become stiff.
A pharmacist can help with sprains and strains
Speak to a pharmacist about the best treatment for you. They might suggest tablets, or a cream or gel you rub on the skin.
Painkillers like paracetamol will ease the pain and ibuprofen will bring down swelling. However, you shouldn't take ibuprofen for 48 hours after your injury as it may slow down healing.
How long it takes for a sprain or strain to heal
After 2 weeks, most sprains and strains will feel better. Avoid strenuous exercise such as running for up to 8 weeks, as there's a risk of further damage.
Severe sprains and strains can take months to get back to normal.
You can't always prevent sprains and strains
Sprains and strains happen when you overstretch or twist a muscle. Not warming up before exercising, tired muscles and playing sport are common causes.
See a GP if:
Go to a minor injuries unit if:
- the injury isn't feeling any better after treating it yourself
- the pain or swelling is getting worse
See a GP if:
- you also have a very high temperature or feel hot and shivery
These could be signs of an infection.
Treatment at a minor injuries unit
You may be given self-care advice or prescribed a stronger painkiller.
If you need an X-ray it might be possible to have one at the unit or you may be referred to hospital.
Physiotherapy for sprains and strains
If you have a sprain or strain that's taking longer than usual to get better, your GP may be able to refer you to a physiotherapist.
Physiotherapy from the NHS might not be available everywhere and waiting times can be long. You can also get it privately.
Go to A&E or call 999 if:
- you heard a crack when you had your injury
- the injured body part has changed shape
- the injury is numb, discoloured or cold to touch
You may have broken a bone and will need an X-ray.