If you’ve ever jogged, chances are you would have experienced shin pain either during or after your run. This common condition is called shin splints. But what exactly causes this pain and do only runners suffer from it? Ms Khoo Shin Jiun, Senior Physiotherapist at the Department of Physiotherapy, Singapore General Hospital (SGH), shares the facts about shin splints.
What are shin splints?
Shin splints, also known as medial tibial stress syndrome (MTSS), refer to shin pain or discomfort due to repeated activity on a hard surface or excessive use of the foot muscles.
If you have shin splints, you may notice:
- Tenderness, soreness or pain along the inner part of your lower leg
- Mild swelling in your lower leg
“Shin splints account for 6 to 16 per cent of injuries in runners. Stats show that about 4 to 7.9 per cent of military personnel suffer from shin splints. For aerobic dancers, the number is higher, up to 22 per cent,” says Ms Khoo.
Causes of shin splints
Shin splints are commonly caused by:
- Muscle imbalance of the lower limbs, including weakness of the core muscles
- Tight calf and plantar muscles
- Improper stretching or warm-ups before exercise or training
- Increasing activity, intensity and duration too quickly
- Running uphill or downhill, or training on uneven terrain or hard surfaces
- Improper or worn-out footwear
People with flat (pronated) feet are likely to suffer from shin splint pain due to a tendency to roll their feet inwards upon landing on the ground. This causes the tibia (shinbone) to twist, overtaxing the muscles around the shin. Having a BMI above 20 also increases one’s likelihood of getting shin splints.
“In severe cases, shin splints can progress to stress fractures. Females are 1.5 to 3.5 times more prone to such fractures,” says Ms Khoo.
She adds, “Initially, shin pain may be present at the start of the activity but subsides with continued exercise. However, prolonged activity will cause the pain to persist. If the symptoms worsen, the pain may exist even after the activity ceases or when performing the most basic day-to-day tasks.”
Management of shin splints
Proper shin splint management depends on the severity of the condition.
In the acute phase, shin splint pain can be treated with rest and ice applied over the affected area to reduce the inflammation. Taking over-the-counter pain relief medication may also help with the pain and swelling. However, physical activity should not be given up altogether. Instead, engage in stretching exercises and exercises that strengthen the lower limb and core muscles.
When foot biomechanical abnormalities may be the cause of shin splints, appropriate footwear or medial arch supports can be used to prevent excessive pronation (inward rolling of the foot) during running.
In severe cases such as a stress fracture, sufficient rest and use of crutches and/or a cast are required until the bone heals, says Ms Khoo. If any of the symptoms persists, do consult a doctor for further investigations.
Prevention of shin splints
To prevent shin splints, you should:
- Do warm-ups and stretch your muscles before any exercise
- Wear appropriate, fitting footwear when running
- Plan smartly when deciding to increase frequency, intensity or duration of any activity
- Include lower limb and core muscle strengthening workouts in your training program