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Tibial Stress Syndrome, Shin Splints Tibial Stress Syndrome, Shin Splints
Shin splints are more common in runners and people that play in sports that involve sudden starts and stops like basketball, tennis or soccer,... Tibial Stress Syndrome, Shin Splints

by Kimberly Allen, RN

Tibial stress syndrome is the medical term for what is more commonly known as shin splints. Shin splints are part of a group of injuries known as overuse injuries.  Shin splints are more common in runners and people that play in sports that involve sudden starts and stops like basketball, tennis or soccer, but  can develop in anyone whether an athlete or not.  They account for up to 17% of all running related injuries.  In people that are aerobic dancers shin splint injuries are as high as 22%.
shin splintsShin splints develop when too much force is placed on the muscles of your lower leg which in turn puts excessive pressure on the connective tissue that connects your muscles to the bones.  This causes the protective sheath that surrounds your bones, known as the periostium, to become inflamed.  In most cases the excess force is put on the muscles of the lower leg by specific  activities like running downhill or on a slanted surface, wearing worn out footwear when running or playing in sports that require you to start and stop suddenly and frequently like tennis or basketball.  Gymnasts that don’t use sufficient matting for landings are also prone to shin splints.
Though shin splints are categorized as an overuse injury many experts feel they are more of a symptom of an underlying problem than a specific medical condition.  Most doctors feel that in addition to certain activities there are other biomechanical problems like flat feet that contribute to shin splints.  In fact flat feet, also known as over pronation, is the most common biomechanical cause of shin splints.  People with flat feet roll their  feet inward excessively which causes the tibia to twist overstretching the muscles of your lower leg. people that run with poor  form like with their toes pointed outward instead of straight ahead while running tend to develop shin splints.  Stress fractures can both lead to shin splints or be caused by shin splints.  Females with shin splints are as much as 3 1/2 times more likely to develop stress fractures from shin splints because diminished bone density is more of a problem in females.  Improper training techniques like increasing your training too quickly, like doing whats called the “terrible too’s” – too much, too fast, for too long.  Running on hard surfaces like cement or running with ankles that have reduced flexibility can cause shin splints to develop.
If you develop shin splints you will experience pain along the inside of your lower leg bone, the tibia.  Most people describe the pain as a dull aching pain.  Some experience pain only during exercise while others state the pain is stronger after exercising.   Still other state the pain is constant whether at rest or exercising.  Some people also develop some swelling that can usually be felt as lumps and bumps along the inside of your shin bone, the tibia.  You may also have pain when you bend your toes or foot downward.
The goal of treatment for shin splints is to reduce the pain and swelling as well as identify the underlying cause.  Treatment of shin splints includes rest from any activities that aggravate or worsen your symptoms.  However, it’s important to maintain your fitness while “resting” by doing non-weight bearing exercises like cycling or swimming.  Using ice or “cold therapy” when you first develop shin splints helps to reduce the inflammation.  It’s also important to elevate you affected leg above the level of your heart to reduce inflammation and promote circulation.  Taking over the counter pain relievers like NDAID’s will also help with the pain and inflammation.  It’s also important to wear proper footwear and consider arch supports as they help to cushion and distribute the stress on your shin bones.
The best way to prevent shin splints is to wear footwear that is appropriate to your sport.  runners should replace their shoes very 350 to 500 miles.  Cross-training with a low impact sport like swimming or cycling and add strength training to your workouts.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at