Shin Splints
Shin splints, medically known as medial tibial stress syndrome (MTSS) is one of the most common causes of pain along the shin bone (tibia), especially in runners and anyone who's recently increased how much running, jumping, or high-impact training they're doing.
What Causes Shin Splints?
Shin splints develop when the muscles, tendons, and the outer covering of the tibia (the periosteum) become irritated from repetitive impact and stress on the lower leg. Common contributors include:
- A sudden increase in running mileage, intensity, or training frequency
- Running on hard or uneven surfaces
- Worn-out or unsupportive footwear
- Flat feet, high arches, or other foot mechanics that change how impact is absorbed up the leg
- Tight calf muscles, which increase strain on the tissue along the shin
Symptoms
- An aching or sharp pain along the inner (or occasionally outer) edge of the shin bone
- Pain that often starts at the beginning of exercise, and in earlier cases may ease once you're warmed up
- Mild swelling or tenderness along a stretch of the shin
- Symptoms that build gradually with training rather than starting from a single injury
Shin Splints vs. a Stress Fracture
This distinction matters, because continuing to train through a stress fracture can make it significantly worse. The most useful clue is the pattern and location of tenderness:
- Shin splints typically cause diffuse tenderness spread across a couple of inches along the shin, and pain that may partially ease once you're warmed up.
- A stress fracture typically causes focal, pinpoint tenderness at one specific spot on the bone, pain that doesn't improve with continued activity, and sometimes pain even at rest.
If your pain is sharply localized to one spot, doesn't ease with activity, or is present at rest, it's worth a prompt evaluation (with imaging if needed) rather than assuming it's a routine case of shin splints.
How We Diagnose It
Diagnosis starts with a hands-on exam: we check the pattern of tenderness along the tibia (diffuse versus focal), assess your foot and ankle mechanics, calf flexibility, and running or training history, and use functional tests such as single-leg hopping to see whether impact reproduces your pain. On-site digital X-ray is available if we need to rule out a stress fracture, and we'll refer you for further imaging if the picture doesn't fit a straightforward case.
Treatment for Shin Splints
The most important part of treatment is backing off the aggravating activity long enough for the irritated tissue to calm down — pushing through pain is what allows shin splints to progress toward a stress fracture. Alongside activity modification, your plan may include:
- Relative rest and a gradual, guided return to running or training, rather than stopping and restarting at full intensity
- Soft tissue therapy for tight calf muscles and the muscles along the shin
- Chiropractic adjustments to the foot and ankle when mechanics there are contributing to how impact travels up your leg
- Footwear and orthotic assessment to better support your foot type and training surface
- Ice and anti-inflammatory measures during the acute, most irritated phase
- Guided strengthening for the foot, ankle, and calf to reduce recurrence once symptoms settle
Most cases improve within a few weeks of appropriate rest and treatment. If pain persists beyond one to two weeks despite backing off activity, or if it's ever sharply localized to one spot, that's worth a follow-up evaluation to rule out a stress fracture.
Frequently Asked Questions
Can I keep running with shin splints? Usually you'll need to reduce or pause high-impact activity for a period rather than running through it since continuing to push through shin splint pain is the main way it can progress toward a stress fracture.
How is this different from a stress fracture? Shin splints cause more spread-out tenderness along the shin; a stress fracture causes pain in one specific spot that doesn't improve with activity. If you're not sure which you have, that's exactly what an evaluation is for.
Can a chiropractor help with shin splints? Yes, particularly by addressing foot and ankle mechanics, tight calf muscles, and guiding a gradual return to activity, alongside identifying and modifying whatever's driving the repetitive strain.
Do I need X-rays? Not for a straightforward case, but imaging is useful if we're trying to rule out a stress fracture.
If shin pain is holding back your training, our Midtown Manhattan team can help you get back to it safely. Call us today or request an appointment online.