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Pain in the shins, following or during exercise is common. Typically, the pain will begin as a dull ache running down one, or more often, both shins.
This shin pain is known as shin splints, and ignoring the pain and continuing to exercise may cause the condition to worsen. Sufferers of shin splints should not attempt to exercise through the pain, as the discomfort could be an indication of injury, either to the bone or the adjacent tissues. It is advisable to discontinue the trigger activity for a minimum of two weeks until the pain has subsided.
There are a variety of causes for shin splints and shin pain. Medial Tibial Stress Syndrome (MTSS) is a common one. This is where the periosteum, the connective tissue covering the shin, becomes irritated and inflamed, usually as a result of excessive pressure on the shins. When an individual carries out new or intense exercise, MTSS can occur. Sports that require frequent stops and starts, such as tennis or netball can trigger MTSS, as can long-distance running. Over-pronation, where the foot rolls abnormally, can also put excessive and irregular force through the tibia and shin.
Stop the activity causing the discomfort immediately. The pain should gradually subside and after about two weeks, it is usually possible to slowly resume the exercise. It is helpful to continue low impact activity during this time.
If there is any swelling, apply an ice pack to the shin for approximately ten minutes. This can be repeated twice or thrice hourly and will also help to relieve the discomfort. Paracetamol and ibuprofen, available over the counter, can be taken to reduce inflammation and pain.
Runners should ensure their trainers provide adequate support. Those with flat feet or with excessive over-pronation may require orthotics (shoe inserts) to correct the position of the foot. Specialist running shops often offer gait analysis and other tests and are able to provide advice accordingly. For more serious and ongoing problems, it may be necessary to consult a podiatrist.
If there is no improvement after two or three weeks of rest, or if the pain becomes worse, the GP may need to look into the problem further. Other causes of shin pain might include:
Stress fractures in the shin
A herniated muscle
Reduced blood supply
A problem with the nerves, either in the legs or the lower back
It may be necessary to see a physiotherapist, who can provide an appropriate exercise and rehabilitation programme.
Following two weeks of rest, it should be possible to gradually increase activity. It may take about three to six weeks to return to previous levels of activity. It is essential to warm up and warm down properly, before and after exercise.
To prevent shin splints and other shin pain in the future, it is important to build up exercise gradually. If possible, steer clear of hard surfaces when training and wear proper supportive running shoes and orthotics if necessary. Increasing general flexibility and strength will also help.