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Lower leg muscles
Lower leg muscles

Shin splints
Definition:
Pain in the front of the lower legs caused by strenuous exercise, usually after a period of relative inactivity.

Alternative Names:
Lower leg pain; Pain - shins; Anterior tibia pain

Considerations:
Shin splints may be any of 4 types of problems, none of which are serious. All types of shin splints can be resolved with rest.
Common Causes:
Posterior tibial shin splints, in the front portion of the legs, account for about 75% of the problems affecting athletes.

Tibial periostitis occurs further toward the front of the leg than posterior tibial shin splints, and the bone itself is tender.

Anteriorcompartment syndrome affects the outer side of the front of the leg.

Stress fracture is usually a localized, sharp pain with tenderness 1 or 2 inches below the knee. This condition is likely to occur 2 or 3 weeks into a new training program after the legs have taken a real pounding.
Home Care:
For posterior tibial and tibial periostitis shin splints, the healing process usually takes a week of rest with ice treatment for 20 minutes twice a day. Over-the-counter pain medications will also help. Running should not begin again for another 2 to 4 weeks.

For anteriorcompartment syndrome, pain will usually subside as the muscles gradually accustom themselves to the vigorous exercise. Complete rest is probably not necessary.

For a stress fracture, rest for at least 1 month is required. Complete healing requires 4 to 6 weeks. Crutches can be used but typically are not necessary.
Call your health care provider if:
  • the pain is prolonged and persistent even with rest.
  • the diagnosis is not definitive or if there is no progress with home treatment after several weeks.
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting your symptom in detail may include:
  • time pattern
    • When did the pain develop?
    • Is it present all of the time?
  • quality
    • Describe the pain.
    • Is it a sharp pain?
  • location
    • Are both legs affected?
    • Where exactly on the leg is the pain?
  • aggravating factors
    • Have you recently begun exercising?
    • Have you recently increased the amount that you exercise?
    • Have you recently changed the type of exercise that you do?
  • relieving factors
    • What have you done for the pain?
    • How well did it work?
  • other
    • What other symptoms are also present?
The physical examination may include an examination of the legs.

Intervention:
Home treatment will be prescribed for any of the different types of shin splints. Surgical intervention might be indicated in the rare event that shin splints caused by an anteriorcompartment syndrome do not go away over time. The pressure can be relieved by splitting the tough, fibrous tissue that surrounds the muscles.

After seeing your health care provider:
You may want to add a diagnosis related to shin splints to your personal medical record.
Review Date: 5/26/2001
Reviewed By: Kevin B. Freedman, M.D., Department of Orthopaedic Surgery, Rush-Presbyterian Medical Center, Chicago, IL. Review provided by VeriMed Health Network.
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