Shin splints (medial tibial stress syndrome)

Pain along the front or inner part of your lower leg can make running, walking or even standing uncomfortable. Shin splints, known medically as medial tibial stress syndrome, develop when the muscles, tendons and bone tissue in the lower leg are overworked, often from repetitive impact activities like running, jumping or marching. With the right care, most people recover fully and return to the activities they enjoy.

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Anatomical diagram showing muscles in the lower leg, labeled as Peroneus longus, Tibialis anterior, Extensor digitorum longus, and Extensor hallux longus.

Anatomy of the lower leg

The tibia, or shinbone, is one of the primary weight-bearing bones in your body. Each time your foot strikes the ground, the muscles and tendons along your lower leg work together to absorb shock and support movement. When these tissues are stressed repeatedly without enough rest, small microtears and inflammation can develop along the bone.

Shin splints typically involve both the muscles of the lower leg and the periosteum, the thin layer of tissue that covers the bone. This irritation is a sign that your leg needs time to heal and rebuild strength.

Overview

Symptoms

You may be experiencing shin splints if you notice:

Dull, aching pain along the inner or front part of the shin
Tenderness or mild swelling in the lower leg
Pain that begins during exercise and may continue afterward
Increased discomfort when running downhill or on uneven terrain
Tightness or throbbing in the lower leg after activity

Symptoms often start gradually and worsen if activity continues without rest.

Causes

Shin splints often result from training errors, muscle imbalances or foot mechanics that increase stress on the lower leg. Common causes include:

Sudden increases in activity, such as adding mileage, speed or hills too quickly
Improper or worn out footwear that doesn't provide enough cushioning or support
Flat feet or high arches that alter the way force is distributed through the leg
Exercising on hard or uneven surfaces
Tight calf muscles or weak hip and core muscles
Repetitive jumping or pivoting movements common in sports like basketball, soccer or dance

Understanding what's contributing to your pain allows our specialists to create a treatment plan that addresses the root cause and helps prevent recurring issues.

Risk factors

Certain factors can make you more likely to develop shin splints, though having one or more of these does not mean you'll experience this condition. Risk factors include:

Rapid increases in training intensity, duration or frequency
Flat feet, high arches or other foot mechanics that affect force distribution
Tight calf muscles or weak hip and core muscles
Worn out or unsupportive footwear
Participation in sports involving repetitive impact, jumping or pivoting

Diagnosis

Our specialists take a patient-centered approach to diagnosing lower leg pain. Your evaluation may include a review of your medical history, activity level and training routine, along with a physical examination to assess tenderness, muscle tightness and biomechanics.

If a stress fracture or another condition needs to be ruled out, imaging studies such as X-rays or MRI may be used. We take time to explain your diagnosis clearly and discuss the best treatment options for your needs.

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