I tried taking up running to stay fit, but I’m getting pain in my shins when I start, which eases off as I continue. I’ve been told this could indicate shin splints. What are they? What causes them? And can they be treated?
By Wendy Haaf
There are a few clues in your case that strongly suggest medial tibial stress syndrome—or more commonly, shin splints: one is location. “A classic presentation is pain in the lower front-inside part of the shin bone,” explains Greg Alcock, a clinical and research coordinator at Fowler Kennedy Sport Medicine Clinic, a London, Ont., organization dedicated to helping people of all ages and athletic abilities stay active. You can pinpoint the pain of shin splints with your fingers, Alcock says, but it worsens when you apply pressure. The discomfort can be confined to a single tender spot or it can extend “over the course of three or four centimetres,” he says. When shin splints first arise, the pain usually “gets a bit better as you go on with the activity, but the area hurts again later,” Alcock adds.
So what’s going on? The shin segment in question is where tendons anchor their muscles to the bone. When there’s too much tension in that attachment, the anchor—along with all of its connections—is pulled and tugged to the point of injury.
This type of overload generally occurs only after vigorous activity— in fact, it’s usually possible to look back and identify the exact day you started having symptoms. It most commonly occurs while engaging in a type of exercise you’re not used to, and that you’re doing over an extended time and at high intensity—often without gradually working up to it. For instance, Alcock says, “with the pandemic, perhaps you haven’t been going to the gym and then you decide to go on a four-hour hike.” Another potential source of overload on the tendon/bone attachment is footwear that isn’t suited to the given activity.
Thankfully, although shin splints can be a nuisance, they’re not a signal of irreversible damage. So as long as you address the issue, you’re not likely to move on to a full fracture.
Two strategies you can try in order to ease the stress of shin splints are ensuring you have a good pair of sportsspecific athletic shoes and modifying any activity that brings on the pain. For example, you might switch to cycling or the elliptical machine instead of running; or you could keep a training diary to help you determine whether the pain lessens when you shorten your exercise sessions. Leaving a rest day between workouts can also help keep shin splints from progressing to something more dire. In the meantime, applying a cold compress 10 to 15 minutes immediately after exercise and then again a few times a day can help ease symptoms.
If the discomfort persists after three or four weeks of making these types of changes, contact a sports-medicine clinic or a physiotherapist for more help.