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.
This page covers:
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
Most sprains and strains can be managed at home using over-the-counter painkillers to ease any pain.
If the injury is minor, you can look after yourself by using "PRICE therapy" and "avoiding HARM". These are described below.
PRICE stands for:
- Protection – protect the affected area from further injury by using a support or, in the case of an ankle injury, wearing shoes that enclose and support your feet, such as lace-ups.
- Rest – stop the activity that caused the injury and rest the affected joint or muscle. Avoid activity for the first 48 to 72 hours after injuring yourself. Your GP may recommend you use crutches.
- Ice – for the first 48 to 72 hours after the injury; apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day. Don't leave the ice on while you're asleep, and don't allow the ice to touch your skin directly because it could cause a cold burn.
- Compression – compress or bandage the injured area to limit any swelling and movement that could damage it further. You can use a simple elastic bandage or an elasticated tubular bandage available from a pharmacy. It should be wrapped snuggly around the affected area, but not so tightly that it restricts blood flow. Remove the bandage before you go to sleep.
- Elevation – keep the injured area raised and supported on a pillow to help reduce swelling. If your leg is injured, avoid long periods of time where your leg isn't raised.
For the first 72 hours after a sprain or muscle strain, you should avoid HARM. This means you should avoid:
- Heat – such as hot baths, saunas or heat packs.
- Alcohol – drinking alcohol will increase bleeding and swelling, and slow healing.
- Running – or any other form of exercise that could cause more damage.
- Massage – which may increase bleeding and swelling.
Moving sprained joints
Most healthcare professionals recommend you don't stop using a sprained joint. The injury will heal quicker if you begin to move the joint as soon as you're able to do so without experiencing significant pain.
Your doctor may be able to teach you a number of exercises that will help you improve the joint's functionality.
If you have a severe ankle sprain, you may be advised not to use it for a while, or even have it put into a cast for a week or so.
Immobilising strained muscles
Depending on your injury, the advice for muscle strains can vary. You may be advised to keep your injured muscle still for the first few days. Your doctor may recommend using a brace, cast or splint to help keep it as still as possible.
The aim of immobilising the muscle is to allow it to start healing, so you can move it without tearing or pulling it again in the same place. After a few days, you'll probably be advised to start using the muscle again.
Paracetamol is usually recommended for painful sprains or strains. If it doesn't help, you may need an additional stronger painkiller – such as codeine – that's only available on prescription.
Your GP may also prescribe a non-steroidal anti-inflammatory drug (NSAID) cream or gel, such as ibuprofen or ketoprofen, to help treat pain. Gently apply the cream or gel to the injured area and wash your hands immediately afterwards.
Ketoprofen can make your skin sensitive to light (photophobia). You should avoid exposing treated areas of skin to direct sunlight or artificial sources of light, such as sunlamps or sun beds, during treatment and for two weeks afterwards.
Oral NSAIDs, such as ibuprofen tablets, can also help reduce swelling and inflammation. However, they shouldn't be used in the first 48 hours after the injury because they may delay healing.
For more severe injuries, particularly muscle strains, your doctor may consider referring you for physiotherapy.
Physiotherapy aims to restore movement and function to an injured area of the body. The physiotherapist may show you exercises to help improve the range of motion and return normal function to the injured area.
This may reduce your risk of experiencing long-term problems or injuring the area again.
The length of time it takes to recover from a sprain or strain depends on how severe it is.
Generally, after an ankle sprain you'll probably be able to walk a week or two after the injury. You may be able to use your ankle fully after six to eight weeks, and you'll probably be able to return to sporting activities after eight to 12 weeks.
For muscle strains, the time it can take to recover can vary considerably. Some people recover within a few weeks, whereas others may not be able to return to their normal activities for several months.
Some people may experience continued problems, such as pain, intermittent swelling or instability, for months, or even years, after the original sprain or strain.
Contact your GP if your injury doesn't improve as expected or your symptoms get worse. They may consider referring you to an orthopaedic specialist for further assessment and treatment.