Athletes often complain of “shin splints” at the start of the season. This pain may occur at the start of the cross-country season or with training for a marathon. This often occurs as one progresses too rapidly without conditioning thin muscles. In addition to overtraining, shin splints may be related to muscle imbalance, faulty technique, and improper footwear.

The pain of shin splints occurs in the leg, along the border of the tibia (shin bone). The muscles of the leg contract with each stride to help absorb the shock of the foot striking the ground. The attachment of the muscle to the bone can become inflamed and painful, leading to “shin splints.”

Treatment of shin splints may include a rest period and anti-inflammatory medications. Physical therapy may be necessary, particularly if a muscle imbalance is a factor. A running coach may address proper running and training technique. A warm-up period, stretching, and icing after exercise may help prevent recurrent pain.

Stress fractures can be confused with shin splints. Stress fractures are tiny “micro-fractures” resulting from small, repetitive stresses. The pain, however, is more confined to one specific area of the bone than is seen in shin splints. Stress fractures may appear on x-rays (if more chronic) but may require an MRI or a bone scan to confirm the diagnosis. The athlete’s pain will dictate whether crutches, a cast, a fracture brace or a simple decrease in running and jumping activity are necessary. Many stress fractures heal in 6 to 12 weeks, if diagnosed early. Once symptoms resolve, a slow and careful return to activities is advised to prevent recurrences.