Shin splints are pains in the front of the lower legs caused by exercise. They usually appear after a period of relative inactivity.

Shin splints can be caused by any of four types of problems, which are only occasionally serious. Most shin splints can be treated with rest.

Tibial shin splints are very common and affect both recreational and trained athletes. Runners are often affected. There are two types, tibial periostitis and posterior tibial shin splints. In tibial periostitis the bone itself is tender.

Anterior compartment syndrome affects the outer side of the front of the leg.

Stress fractures usually produce localized, sharp pain with tenderness 1 or 2 inches below the knee. A stress fracture is likely to occur 2 or 3 weeks into a new training program or after beginning a harder training program.

For posterior tibial and tibial periostitis shin splints, the healing process usually takes a week of rest with ice treatment for 20 minutes twice a day. Over-the-counter pain medications will also help. Do not resume running for another 2-4 weeks.

For anterior compartment syndrome, pain will usually subside as the muscles gradually accustom themselves to the intense exercise. Complete rest is probably not necessary.

For a stress fracture, a rest period of at least 1 month is required. Complete healing requires 4-6 weeks. Crutches can be used but typically are not necessary.

Although shin splints are seldom serious, you may need to call your health care provider:

• If the pain is prolonged and persistent, even with rest
• If you are not sure your pain is caused by shin splints
• If there is no progress with home treatment after several weeks

The health care provider will perform a physical examination and will obtain your medical history.

Medical history questions documenting your symptom in detail may include the following:

• Time pattern
  • When did the pain develop?
  • Is it present all of the time?
• Quality
  • Describe the pain.
  • Is it a sharp pain?
• Location
  • Are both legs affected?
  • Where exactly on the leg is the pain?
• Aggravating factors
  • Have you recently begun exercising?
  • Have you recently increased the amount that you exercise?
  • Have you recently changed the type of exercise that you do?
• Relieving factors
  • What have you done for the pain?
  • How well did it work?
• Other: What other symptoms are also present?

The physical examination may include an examination of the legs.

Home treatment will be prescribed for any of the different types of shin splints. Surgical intervention might be indicated in the rare event that shin splints caused by an anterior compartment syndrome do not go away over time.

The pressure can be relieved by splitting the tough, fibrous tissue that surrounds the muscles. Surgery may also be necessary in the cases of non-healing stress fractures.