What causes shin splints?

Shin splints are a frustrating and niggling injury that can significantly hold back an athlete's training. As someone who suffered from shin splints for about two-and-a-half years, I understand the struggle. In this post, we'll dive deep into what causes shin splints and how you can manage them effectively.

What causes shin splints?

The tibialis posterior acts as your natural, built-in orthotic muscle. When overloaded, it develops trigger points to cope with the stress, leading to muscle inhibition and reduced power. Over time, this stress is transferred to the bone, tendon, and periosteum, creating a vicious cycle of overload, inhibition, atrophy, and weakness.

This overload then causes the tib post to lay down trigger points as a way of dealing with the stress. These trigger points inhibit the muscle and shut off the power. Over time, that muscle being inhibited sends more of the stress into the bone, the tendon, and that periosteum.

So you get into this vicious cycle of overload, inhibition, atrophy, and weakness, and you just go around and around and around. The same thing happens at knees: a knee gets grumpy and sore, whether it be the tendon or the patello-femoral joint, and then what happens is that VMO muscle, your protector, starts to shut off and become inhibited, and the same thing, you go around this vicious cycle of pain, weakness, and then muscles that aren’t doing their job when they're supposed to be protecting us.

Shin splints (we are talking posteior shin splints now and for the rest of this article) occur when the tibialis posterior muscle becomes overloaded, inhibited, and starts pulling on the periosteum on the medial tibia bone. This overload can be caused by various factors, including:

1. Sudden spike in training volume
2. An accumulated block of high volume or high intensity training
3. Accumulation of ground reaction forces
4. Poor foot biomechanics or running technique (e.g., heel striking)
5. Weak calves
6. Generally weak legs or core
7. New shoes or old shoes being worn past their lifespan

Posterior shin splints vs anterior shin splints

Shin splints can be classified as either posterior or anterior, depending on the location of the pain.

Posterior shin splints

Pain is felt along the inside or back edge of the shin bone (tibia) and is caused by inflammation of the tibialis posterior muscle or tendon. This shin pain is the more common (in our gym at Core Advantage) and seems to be linked with a heavy heel-first running technique, rapid pronation in the foot and general poor strength and power in the lower body.

Anterior shin splints

Pain is felt along the front of the shin bone and is caused by inflammation of the tibialis anterior muscle or tendon. To be honest, we have worked a lot less with anterior shin splints and they seem less common in the athletes we work with. This article focuses on a treatment and solution for posterior shin splints pain (along the inside and back edge of the shin bone)

While both types of shin splints can be painful and hinder training, posterior shin splints are more common and often more challenging to treat.

Shin Splints Symptoms

The primary symptom of shin splints is pain along the shin bone. This pain can be sharp or dull and may increase during exercise. Other symptoms can include:

• Tenderness along the inner part of the lower leg
• Mild swelling in the lower leg
• Tightness or stiffness in the shin area
• Pain that worsens with activity

Common Causes of Shin Splints

Shin splints occur when the tibialis posterior muscle becomes overloaded, inhibited, and starts pulling on the periosteum on the medial tibia bone. This overload can be caused by various factors:

Weak calves and shin splints

Weak calf muscles can be a contributing factor in shin splint pain, particularly the soleus and tibialis posterior, can contribute to shin splints. These muscles play a crucial role in stabilizing the lower leg during movement.

Weak legs

Generally weak legs or core can lead to poor biomechanics and increased stress on the shin area during activities like running or jumping. In particular weak hip muscsles, hamstrings and intrinsic muscles of the foot can be factors that lead to overloaded shins.

Running technique

Poor foot biomechanics or running technique (e.g., heel striking) can significantly increase your risk of developing shin splints. A heavy heel-first running technique and rapid pronation in the foot are often associated with posterior shin splints.

Poor running load management

Sudden spikes in training volume or intensity, or an accumulated block of high volume or high-intensity training, can overload the muscles and bones in your lower leg, leading to shin splints.

Shin Splints Self-Care

While it's important to address the root causes of shin splints, there are several self-care strategies you can employ to manage the symptoms and support recovery:

Calf Sleeves

Compression calf sleeves can help improve blood flow and reduce swelling in the affected area. They may also provide some support during activity.

Good Shoes

Wearing appropriate, well-fitted shoes for your activity can help improve your biomechanics and reduce stress on your shins. Consider getting a professional fitting at a specialty running store.

How to fix shin splints

Fixing shin splints requires a multi-faceted approach that addresses the root causes of the issue. Here's a comprehensive plan to help you overcome shin splints:

Rest and modify activity

Give your shins a break by reducing or modifying activities that cause pain. This doesn't mean complete inactivity – try low-impact exercises like swimming or cycling to maintain fitness.

Ice therapy for shin splints

Apply ice to the affected area for 15-20 minutes, several times a day, especially after activity. This can help reduce inflammation and pain, however it is important to note this will not cure your shin splints in the long term.

Good quality running shoes

Ensure you're wearing appropriate shoes for your foot type and activity. Consider getting fitted at a specialty running store.

Gradual return to activity

Once pain subsides, slowly reintroduce your regular activities, increasing intensity and duration gradually.

Address biomechanical issues

Work with a running coach or physical therapist to improve your running form, focusing on a midfoot strike and proper foot placement.

Soft tissue work

Use a foam roller or massage ball to release tension in your calves and shins. This can help improve flexibility and reduce pain.

Remember, recovery takes time and consistency. Stick with your rehab plan and be patient – your shins will thank you in the long run!

Strength Training for Shin Splints

Incorporating strength training exercises, particularly for the lower body, can help build resilience and prevent shin splints. Focus on exercises that target the calves, tibialis posterior, and overall leg strength.

Seated calf raises and isometric holds are one of the most effective exercises you can do.

We have written more about calf raises and shin splints in this blog post.

Stretching for Shin Splints

While stretching alone won't solve shin splints, incorporating specific stretches into your routine can help alleviate tension and improve flexibility. However, it's crucial to balance stretching with strength training for the best results.

Learn more about stretching for shin splints here.

How to prevent shin splints

Preventing is often better than cure. Here's how you can reduce your risk of developing shin splints.

The first and most important piece is to build your strength levels. Both local strength in the soleus and tibialis posterior with the calf isometrics listed above and also general lower body strength.

If you are interested in some coaching and more specific help with your shin splints or a strength program for managing your shin splints, and getting out of pain, get in touch with me (Jacob) directly, I'd be happy to help with some free coaching.

‍Email coach Jacob here →

The key factors for reducing the risk of developing shin splints is very similar to what you would do to fix or heal shin splints as discussed above, there are a number of other factors. Below is a good starting list to consider:

1. Gradual load management: Avoid sudden spikes in training volume or intensity.
2. Running technique work: Focus on proper form and avoiding heel striking.
3. Proper warm-up: Incorporate dynamic stretches and activation exercises before training.
4. Strength training: Target the entire leg, including the calves, to build resilience.
5. Calf isometrics: Incorporate the seated calf isometric holds into your routine.

When to Seek Professional Help

If your shin splints persist despite self-care measures, or if the pain is severe or interfering with your daily activities, it's time to seek professional help. A sports medicine doctor, physical therapist, or experienced coach can provide a more detailed assessment and create a tailored treatment plan.

Remember, shin splints are often a sign of underlying biomechanical issues or training errors. Addressing these root causes is key to long-term relief and prevention. Don't hesitate to reach out to a professional if you're struggling with persistent shin pain – getting expert help sooner rather than later can save you months of frustration and lost training time.

Shin splints exercises

Shin splints can be a frustrating injury, but with the right rehab protocol and preventive measures, you can overcome this condition and get back to training at your best. By understanding the causes, focusing on the appropriate exercises, and gradually managing your load, you'll be well on your way to beating shin splints for good.

For guidance and assistance with your shin pain, get in touch with me (Jacob) directly, I'd be happy to help!

Email coach Jacob here →