Shins sore after running? This video will explain Shin splints, and how to get rid of painful shins. We explain the cause of Shin Splints, or Medial Tibial Stress Syndrome (MTSS), best exercises and rehab for running.


Struggling with shin pain, the dreaded shin splints? Well, stick around we’ll explain what shin splints are, what causes them, and most importantly how to get rid of them. G’Day guys and girls, it’s Anthony from grandstand clinic and today’s topic is shin splints.

Now shin splints is just a generic term for shin pain and there can be a number of pathologies which are causing that pain. Most importantly we need to be able to differentiate between our shin splints and a possible stress fracture. Shin splints are most often characterised by diffuse area of pain running along the inside of your shin whereas a stress fracture tends to be a little bit more focal. If in any doubt, get yourself checked out because you don’t want to miss a stress fracture. Today we’re going to be talking about what commonly is known as shin splints but is more accurately known as medial tibial stress syndrome. Medial tibial stress syndrome or MTSS is most often caused by the action of the muscles pulling on the outside of the bone. Like in this model, the constant pulling action of the muscle on the bone will irritate the skin of the bone or the periosteum, leading to an inflammation and pain at that point. Most commonly the athlete will complain of pain along the inside of the shin bone and you often find that this pain reduces as they start their warm-up and get into their exercise. As they cool down after exercise they may find that’s when their shin pain increases and it may be particularly bad the following day after exercise. Some of the factors you should be aware of that’ll make shin pain worse is a rapid increase in the amount of exercise, a change to harder surfaces when your exercise or a change in your Footwear. Shin splints are especially common in the preseason when an athlete returns to running activities after having had a period of rest.

To manage shin splints we want to look at it from two perspectives, the first being how to offer immediate symptomatic relief and secondly how to prevent it in the long term. Shin splints will be eased by rest, but to be honest if you were the type of person to rest you probably wouldn’t have shin splints to start with. So what we can look at doing is a relative rest, so see if we can cut down some of the impact activity that we’re doing in the most acute phase. It’s often useful to tape the foot using modified Low Dye to provide the arch support and this will take some of the pressure off the muscles which are pulling on the bone. Because there is an inflammatory component to shin splints they will respond well to ice and anti-inflammatories. A really neat trick that we use with our athletes who absolutely have to try and despite the shin pain is to use a bead of anti-inflammatory gel run down the area of soreness you can then wrap the leg up in glad wrap and this will do two things: it’ll allow the cream to be absorbed exactly where the soreness is, it’ll also stop you leaving a trail of anti-inflammatory gel through the house. We recommend doing this before you go to bed and sleeping with the anti-inflammatory gel and glad wrap on your legs. This is not a long-term cure but it will give you some symptomatic relief. Like always, stretching plays a part in the management of shin splints in the acute phase. You should be targeting the calf muscles particular the deeper calf muscle, the soleus and the flexors of the toes and here’s a demonstration of a stretch which is going to stretch those toe flexors. Time under tension in stretching is the key, the longer you hold the stretch the more beneficial the stretch is going to be for you. Foam rolling is another effective way of reducing the calf tightness and for best  results change the angle which you are rolling. For a lot of our patients we find good relief from shin splints can be found by using a trigger ball and working under the arch of the foot to release those flexor muscles. Simply work your way around the bottom of the foot using the ball paying close attention to those tender and tight spots. You should be able to decrease those spots in a matter of minutes.

For the management of shin splints in the long term there’s a couple of issues that we need to pay attention to. Firstly review your training calendar and look for those spikes in training load which may have started the whole inflammatory process. Secondly we should have a look at the biomechanics of the foot. If you’re someone who pronates more when you are running then you might be the type of person who is more prone to developing shin splints. If this is the case with you, measures that reduce the pronation will help to decrease the symptoms. Have a look at your choice of shoes and look for a shoe that offers some rigidity through the mid foot because this’ll guard against excessive pronation. Choosing a more flexible shoe won’t offer the support you need and will probably just mean you’re going to exacerbate your symptoms whilst exercising. You may do really well with an arch support or orthotic within your shoe to unload all those muscles. In the longer term, strengthening the soleus muscle and the tib post muscle will help to prevent shin splints in the future. In this modified calf raise, you can see we move from a pronated position to a supinated position and this is an attempt to try to engage more soleus and tib post involvement in the exercise and thereby help to strengthen it. If we’re strengthening the muscles that attach to the medial border of the tibia we’ll also strengthen that junction of the muscles to the bone. This will make us less likely to irritate that junction as we change our exercise in the future. So in the short term our management for medial tibial stress syndrome is relative rest, using ice, anti-inflammatory gels and stretching the muscles that are attaching to the bone. In the longer term the best way to manage our shin splints is just being aware of the effect of spikes in our training load, particularly during the preseason. Following that we need to address the biomechanical factors, most importantly the increase in pronation. This can be done by using an orthotic or arch support in your shoe or by training the muscles to control the pronation better. With a little bit of attention to detail we’ll find that we can not only reduce the symptoms but also reduce the likelihood of suffering with shin soreness in the future.

If you have shin soreness let us know how you get on with these management strategies in the comments below. I hope this video has given you some ideas in terms of managing your shin pain. If you’ve found it useful, again, hit the ‘like’ button, consider SUBSCRIBING and we’ll catch up with you in the next video.