Shin pain is a broad term that describes pain or discomfort in or around the shin bone. Shin pain can be caused by a sudden injury, called acute pain. However, in most cases shin pain develops over a period of time.
Learn more about how shin pain develops when running and walking, and how to prevent it.
What are the symptoms of shin pain?
Symptoms of shin pain can vary, but may include a dull ache, tenderness, redness, or swelling. In some cases, symptoms of bruising, cramping, numbness, and weakness may also develop. Symptoms can be aggravated by running, walking, jumping, and other high impact exercise.[1]
What causes shin pain?
Shin pain can be caused by several different conditions. Below is a list of the top three conditions that Australian physiotherapists encounter. Also included is a brief treatment plan for each of these conditions.
1. Shin splints
Medial tibial stress syndrome, commonly known as shin splints, is a condition that affects the medial (inner side) of the tibia bone (one of the two leg bones).[1] It is a cumulative stress disorder that is commonly seen in runners, dancers, and in jumping sports.
Pain is caused by repetitive stress, particularly in situations where physical training is intensified or increased suddenly. This overworks the structures in the leg, causing inflammation and a stress reaction in the bone. Biomechanical factors such as incorrect sporting technique or foot position can contribute to this stress. Without adequate rest, this stress reaction can accumulate, and the symptoms can become so severe that even walking can become painful.
Symptoms of shin splints
The common symptoms of shin splints include:
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A dull ache on the inner side of the shinbone
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Pain during high intensity exercise, such as running or jumping
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The area is sore or tender to touch
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Minor front leg swelling.
Treatment of shin splints
Shin splints can usually be resolved with certain treatments, including:
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Rest - As shin splints are caused by overuse, a period of relative rest can be beneficial to help healing. A physiotherapist can help reintroduce exercise, beginning with low impact exercise such as swimming or cycling.
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Pain relief - A doctor may prescribe pain relief, such as paracetamol or ibuprofen.
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Cold pack - Ice can be helpful to provide short term pain relief and to reduce swelling. It is important to apply this correctly to avoid ice burns to the skin.
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Podiatrist - A podiatrist can analyse the foot position and recommend the appropriate footwear or shoe inserts to correct any biomechanical factors.
2. Stress fractures
Stress fractures are tiny cracks or breaks in the bone caused by overload or repetitive stress to the bone. Inadequate recovery and biomechanical factors can contribute to the stress placed on the muscles, tendons, and bones.
People who play high impact sports that involve a lot of running are particularly prone to stress fractures.[2] It is commonly seen in sports such as soccer, athletics, and long distance running.
Symptoms of stress fractures
Symptoms of stress fracture include:
Treatment of stress fractures
In the acute phase, stress fractures may be managed with the R.I.C.E. method.
R: Rest – Stop the activity that is causing the symptoms, whether that is the walking, running, or any other triggering activity. The leg must be rested until cleared by a doctor. A doctor may recommend a brace or crutches to reduce weight bearing through the leg.
I: Ice – An ice pack can be applied to the affected area to help reduce pain, swelling, and inflammation.
C: Compression – Providing compression to the lower leg can help reduce any excessive swelling. It is important to do this correctly to avoid worsening the symptoms.
E: Elevation – Resting with the leg in an elevated position can help alleviate symptoms.
It is important to consult a doctor, who may order further investigations, such as an X-ray, to confirm the diagnosis. The doctor will recommend the appropriate treatment plan based on the results.
3. Compartment syndrome
Compartment syndrome occurs when pressure builds up in the front compartment of the lower leg, either from internal bleeding or swelling.[3] The cause can be acute, such as after an injury or constriction to the lower leg. It can also be caused by chronic conditions, such as overuse or excessive exercise without adequate recovery. It is a condition that affects runners, basketball players, and skiers.
Acute compartment syndrome is a medical emergency. As pressure builds up from internal bleeding or swelling, it can cause nerve damage and tissue death as the blood supply cuts off. In some cases, emergency surgery may be required.
Symptoms of compartment syndrome
Compartment syndrome may cause the following symptoms:
Treatment of compartment syndrome
Treatment for compartment syndrome typically includes:
Preventing shin pain during walking or running
Ways to reduce shin pain include:
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Completing a thorough warm-up before exercise
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Wearing proper footwear, including any orthotics
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Avoiding sudden increases in exercise intensity or duration
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Using the correct technique for sport
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Consider cross-training with low-impact sports, such as swimming or cycling
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Avoid long workouts on hard surfaces or uneven terrain
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Respect any pain signals – do not push through the pain.
Things to consider about shin pain
Shin pain can be caused by different conditions, including shin splints, a stress fracture, or compartment syndrome. If the pain is severe or persistent, or if there are any unusual symptoms, it is important to consult a doctor for further investigation. Diagnosing the cause of the discomfort can help develop the appropriate treatment plan.
