Shin splints” is a term for a spectrum of pain in the front of the shin. The condition—very common in runners—can result from a stress injury (irritation of the bone) or a stress fracture (actual crack inside the bone). You’ll know you have shin splints if your shin bone (tibia) hurts when you press on it firmly with your finger.
The causes of shins splints include problems with body mechanics, a sudden or excessive increase in the amount or intensity of activity (“too much, too soon”), and low bone density.
Body mechanics (how someone is built) includes foot type (often corrected with orthotics or by wearing a type of shoe that limits pronation or inward rolling of the foot), and running style, which can be influenced by strengthening the hip and core muscles.
A runner who increases mileage or intensity too quickly, such as by doing too many speed workouts or overracing, can develop shin splints due to excessive muscle tightness or other factors. To avoid this problem, follow the “10% rule”: increase mileage no more than a 10% per week. Keep in mind, though, that everyone is different and that even 10% may be too much of a weekly mileage increase for some runners.
The causes of low bone density include genetics, poor dietary calcium or vitamin D intake, and a history of menstrual disorders, meaning a gap of six months or longer between periods. This causes low levels of circulating estrogen, which affects bone density.
Once a diagnosis of shin splints is made, it’s important to figure out the level of severity (stress injury or stress fracture) in order to determine the right treatment. If you’ve had shin splints before, you can reduce the risk of a recurrence by getting the right shoe for you, trying an orthotic in that shoe, adjusting your training schedule, or getting a bone density test called a DEXA, which looks for low bone density as a possible cause of the injury. A team of sports medicine experts can help you put shin splints behind you and keep running strong.
—Dr. Jordan Metzl
Dr. Jordan Metzl is a sports medicine physician at Hospital for Special Surgery. His focus is to safely return athletes to the playing field of their choice and to keep them there. Dr. Metzl is an award winning author and medical columnist for Triathlete Magazine. His books include The Young Athlete (Little Brown) and The Athlete’s Book of Home Remedies (Rodale). Dr. Metzl is a 29-time marathon runner and 10-time Ironman finisher.