(See also Overview of Sports Injuries.)
Repetitive impact forces in the legs during running or vigorous walking (such as hiking) can overload the muscles and tendons in the legs and cause shin pain. Excessive outward rotation of the foot on the leg (supination) may also cause or exacerbate shin splints.
Pain can be in the front outer aspect of the leg or the back inner part of the leg. Shin splint pain typically begins at the start of activity but then lessens as activity continues. At first, the pain is felt only immediately after the heel strikes the ground during running or walking. If the person continues to run, the pain occurs throughout each step, eventually becoming constant. Pain usually disappears with rest.
Running must be stopped until it causes no pain. Applying ice and using nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain. Conditioning can be maintained with alternative exercises, such as swimming.
Once shin pain starts to subside, exercises to stretch and strengthen the muscles in the legs, such as the bucket-handle exercise, can be done. The exercises are important to avoid recurrence. Wearing supportive shoes with rigid heel counters and arch supports and avoiding constant running on banked or hard surfaces may help prevent shin splints from recurring.