Shin Splints

What are shin splints?

Shin Splints (Medial Tibial Stress Syndrome) is a condition characterised by damage and inflammation of the connective tissue joining muscles to the inner shin bone (tibia).

There are several muscles which lie at the back of your lower leg and are collectively known as the calf muscles. Several of these muscles lie deep within the calf (tibialis posterior, flexor digitorum longus, flexor hallicus longus and soleus) and attach to the inner border of the shin bone (tibia). The connective tissue responsible for attaching these muscles to the tibia is known as the tenoperiosteum. Every time the calf contracts, it pulls on the tenoperiosteum. When this tension is too forceful or repetitive, damage to the tenoperiosteum occurs. This results in inflammation and pain and is known as medial tibial stress syndrome– commonly referred to as shin splints.

Medial tibial stress syndrome can sometimes occur in combination with other pathologies that cause shin pain such as compartment syndrome and tibial stress fractures.

N.B. Medial tibial stress syndrome has only recently fallen into the catergory of shin splints, the main conditions that fall into this catergory are; stress fracture, myositis, periositis, tendinotis, compartment syndrome, fasciitis and ischaemic disorders.

Causes of shin splints

Shin splints most commonly occur due to repetitive or prolonged activities placing strain on the tenoperiosteum. This typically occurs due to excessive walking, running or jumping activities (such as an increase in physical exercise) and is often seen in runners and footballers. It frequently occurs in combination with calf muscle tightness or other biomechanical abnormalities, such as excessive pronation or supination (high arch), or in those who consistently wear inappropriate footwear. Athletes more commonly develop this condition early in the season following a period of reduced activity (deconditioning) and when training surfaces are generally harder.

Signs and symptoms of shin splints

Patients with shin splints typically experience pain along the inner border of the shin. In less severe cases, patients may only experience an ache or stiffness along the inner aspect of the shin that increases with rest (typically at night or first thing in the morning) following activities which place stress on the tenoperiosteum. These activities typically include excessive walking, running (especially up hills, on uneven surfaces or in poor footwear), jumping and general weight bearing activity.

The pain associated with this condition may also warm up with activity in the initial stages of injury. As the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance. In severe cases, patients may walk with a limp, although this may also reduce to some extent as the patient warms up.

Patients with this condition typically experience pain on firmly touching the inner border of the shin bone, particularly along the lower third of the bone. Areas of muscle tightness, thickening or lumps may also be felt in the area of pain. In severe cases, swelling, redness and warmth may also be present.

Prognosis of shin splints

Most patients with this condition heal well with appropriate treatment. Recovery time may range from a few weeks to many months depending on the severity of injury, quality of treatment and length of time the injury has been present for. Patients with shin splints that have been present for months may require a considerable period of treatment associated with reduced activity before full recovery occurs.

Contributing factors to the development of shin splints

There are several factors which can predispose patients to developing this condition. These need to be assessed and corrected. Some of these factors include:

  • Excessive training or activity
  • Poor foot posture
  • Inappropriate footwear
  • Inadequate warm-up
  • Training on hard or inappropriate surfaces
  • Muscle weakness (especially the calf muscles)
  • Tightness in specific joints (such as the ankle)
  • Tightness in specific muscles (especially the calfs)
  • Poor lower limb biomechanics

Shin Splints Treatment

It is important to highlight that the best treatment for shin splints is treating the cause, rather than the symptoms, as previously discussed there has been a lot of research conducted which shows a rolled in foot/ over pronated foot or high arch foot will cause shin splints. By changing and optimizing foot and leg biomehcanics, we can treat the condition of shin splints. There are ways of dealing with the pain in-between time which include;

  • Deep tissue massage (particularly to the calf muscles)
  • Joint mobilization
  • Taping
  • Orthotics
  • Biomechanical correction
  • Progressive exercises to improve flexibility (especially of the calf muscles)
  • Activity modification advice
  • Footwear advice
Shin Splints

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34 Sussex Road, Haywards Heath, Sussex RH16 4EA

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Great, friendly service. Would happily recommend.
J K
J K
09/05/2022
I was in so much pain with my right foot because I got a cyst in it and just found Sussex Foot Centre in google and called them for booking appointment. The person I talked with was so helpful and they offered appointment on the same day. Everybody working at this place were so friendly and experienced. At my first appointment I had a consultation with ultrasound scan and clearly described me the next steps what would solve my problem and it really reassured me because I was so scared and tired from the pain and for long waiting time on GP referrals. For the treatment, I got an appointment on next day (again so fast!!) and already when I came out from the Centre could walk much better and the pain disappeared. I am so grateful for them and still going back for regular checking and advices. I also having issues with my nails too and I am sure I could get a quick solution on those issue too! Everybody having issue with their foot please don't hesitate to get in touch with Sussex Foot Centre - just give a try and I am sure you will don't disappoint! For me honestly was a life-saver. Thank you so much!
Tundi Bodi
Tundi Bodi
03/05/2022
Highly recommended due to efficient, spotless, courteous staff with on time treatment. You could take a good step forward by using this team.
Brian Beesley
Brian Beesley
03/05/2022
Excellent podiatrist- knowledgeable, professional, caring and quick. Thanks!
Murdo Guy
Murdo Guy
25/04/2022
I can't thank this gentlemen enough. Pain in my foot had effected my whole life, no running, no water aerobics no tai chi and most of all no work as I'm a cook. Scan first visit, problem located plan worked out, return week later double appointment as we live hour away. Another scan, walk on treadmil, insole made...meanwhile he explained everything, so I could understand. I. Very impressed with the whole experience, and would recommend them to anyone
lyn murphy
lyn murphy
15/04/2022
I have had toe nail surgeries with the Sussex Foot Centre and both times have had very positive experiences. Jon provided excellent treatment and care during the surgeries and in the follow up post surgeries. Jon and Thomas were professional and friendly and they have been so flexible and accommodating with scheduling appointments, as well as providing quick responses by email and telephone. I would recommend the Sussex Foot Centre. Thank you so much!
Josephine Zamat
Josephine Zamat
08/04/2022
Jon Collins and team provide excellent patient focused, customer focused care. I have not met a better podiatrist than Jon in over 30 years in healthcare management and 10 years as a patient. As you step into reception you are welcomed with both smile and greeting. Even though it is a busy practice, changes in appointment are politely and readily managed. Forgetfulness and a missed appointment are taken in their stride! I attended first as an ”emergency” patient, three years ago. I was at the local hospital and the Sussex Foot Centre was suggested. I was seen the same afternoon. After months of hobbling, Jon treated my foot with professional skill, exuding warm reassurance. Regular attendance and treatment ensured rapid improvement. The specially created insole proved to be a boon. I have remained with Jon as my podiatrist for three years now. I can think of no reason why I should go elsewhere. I have no hesitancy in recommendinng him. When my GP asked me why I go over to Haywards Heath, my reply was that he is the best.
Malcolm Boyland
Malcolm Boyland
05/04/2022
The treatment and service from Sussex Foot Clinic was excellent and I would highly recommend them to anyone. Over the counter and home remedies had failed miserably. Investing in some professional treatment and following it through diligently was well worth it. Thank you Jon.
E M Drake
E M Drake
24/03/2022
I found The Sussex Foot Centre via Google and what a find! I started seeing Jon last summer with painful Plantar Fasciitis in both feet. With Jon’s knowledge, non invasive treatment and orthotics, I am so grateful to him for my pain free feet now! Jon and his team are so helpful, with total professionalism and extensive knowledge - I have learnt so much! Tom on reception is also so very friendly and efficient. Keep up the amazing work you all do.
Lisa Bailey
Lisa Bailey
21/03/2022
A first class service. A friendly, highly professional medical approach . I have had effective, pain-free treatment for my footcare. Highly commended.
Ollie Swan
Ollie Swan
20/03/2022