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Q&A: How to Treat Shin Splints

I have a lot of pain in the front of my calves. My friend says it’s “shin splints.” What does that mean and what can I do about it?


 This time of year, as marathon season peaks, I see hundreds of runners each month in my office complaining of “shin splints.” When runners increase their workout intensity or change surfaces (dirt, treadmill or pavement) they can find themselves faced with this common overuse injury.

The pain of shin splints generally falls into two categories: bone-related and muscular. Bone-related pain is the much more common type, and it happens when the bone lining (periosteum) is irritated. The muscular type, a less common entity called exertional compartment syndrome, occurs when the muscles grow too big for the wrapping that encases them (fascia). A sports-medicine doctor will perform an exertional-compartment test to measure the pressure inside the leg before and after exercise, looking for a large pressure buildup. If the diagnosis is confirmed, surgery may be necessary.

The good news that many cases of shin splints heal on their own. However, it is best to see a physician to get the right diagnosis and treatment plan. I have found both in my office as a sports medicine doctor and out on the road as a runner (this year I'll be doing my 31st marathon in NYC) that understanding running injuries and knowing a few prevention techniques can help you go the distance. Here are some suggestions:

1. Rest: As runners we’re constantly pushing our bodies, but keep in mind that our bodies need time to heal.
2. Ice: Do 20 to 30 minutes every three to four hours. It’s the best way to ease pain and reduce swelling.
3. Anti-inflammatory medications: Consult a physician for the best treatment for you.
4. Orthotics (arch supports) and motion-control running: Runners who have shin splints or pain along the inside part of their shin do best with a motion-control shoe that limits their pronation (the slight inward rolling motion that the foot makes during a normal walking or running stride).
5. Work with a physical therapist or certified athletic trainer: A trained professional can manually loosen the fascia and prescribe with a good stretching and cross-training program.

It’s difficult to determine how long it will take for shin splints to heal. Once the problem has been diagnosed, the most important thing is to correct it so that you don’t permanently injure yourself.


Dr. Jordan Metzl

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), and the upcoming Exercise Cure (Rodale). Dr. Metzl is a 30-time marathon runner and an 11-time Ironman finisher.

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