Understanding Shin Splints in Running, Gymnastics and Sports
Shin splints are one of the most common injuries seen in athletes, particularly those involved in high-impact sports like running, gymnastics and basketball. While they often start as a minor ache, shin splints can quickly progress to impacting performance and turning into a stress fracture if not addressed properly. Understanding the causes, symptoms, and strategies for prevention is key to staying healthy and strong.
What Are Shin Splints?
“Shin splints,” or medial tibial stress syndrome (MTSS), start as a muscle and tendon injury and worsens to add stress to the tibial bone if an athlete continues repetitive impact activities before the muscle heals. They are an overuse injury, which means the muscles running along the shins are not strong enough to endure the amount or frequency of stress they are experiencing. Anterior shin splits primarily affect the anterior tibialis muscle and causes pain in the front outside of the shin. This muscle causes the foot to flex upward AND helps absorb forces in the leg on landings. Posterior shin splints primarily affect the tibialis posterior and causes pain more on the inside of the shin. This muscle helps with the pushoff and inward movement of the foot when running. Runners often experience shin splints when they rapidly increase the intensity of their training such as increasing the number of miles they run each week. Gymnasts often experience shin splints when they too rapidly increase intensity of training on vault or floor, the highest impact events.
Common Shin Splint Symptoms
- A dull, aching pain along the front outer part of the shinbone (anterior shin splits) or inner part of the shinbone (posterior shin splits)
- Tenderness or soreness when pressing on the shin
- Pain that worsens with resisted foot lift (anterior) or foot point with inward rotation (posterior)
- Pain that specifically worsens with high impact activities like running
Ignoring these signs can lead to more severe injuries, such as stress fractures. When the shin bone muscles are injured and cannot adequately protect the shin bone from stress, continuing high impact activities begins to affect the bone.
Risk Factors for Shin Splints
Several factors contribute to the development of shin splints:
Several factors contribute to the development of shin splints:
- Overtraining: Rapidly increasing training volume or intensity without proper progression.
- Improper Footwear: Shoes that don’t provide enough support make the shin muscles work harder and wear down faster.
- Hard Training Surfaces: The harder the surface, the harder the shin muscles have to work to cushion the landing.
- Poor Single Leg Strength and Stability: Weakness in the hips, core, or legs can cause single leg stability (which is supposed to be the job of big muscles) to be controlled by the ankle and shin muscles. This overworks them over time.
- Biomechanical Issues: Flat feet (overpronation) or high arches that change shock absorption.
Prevention Strategies
Preventing shin splints means adequately preparing your shin muscles for the intensity of training required in your sport. Here’s how runners, gymnasts and other athletes can protect their bodies:
1. Prioritize Proper Warm-Up
Begin every practice or workout with a dynamic warm-up to prepare muscles and joints. Light jogging before sprinting, jumping before explosive rebounds. A warm muscle is significantly less prone to injury than a cold muscle.
2. Improve Single Leg Strength and Stability
Build strength in the calves, hips, and core to improve stability and reduce stress on the shins. The focus during stability exercises is the correct alignment and movement pattern. These exercises start as simply as static single leg balance, progress to dynamic single leg balance, and become high resistance into lunging variations and single leg hopping as soon as they can be done with correct form.
3. Improve Strength of the Tibialis Anterior and Tibialis Posterior
In addition to gradual increases in activity an athlete can also specifically complete resistance training for the tibialis anterior and tibialis posterior. If these muscles are stronger then they are less likely to wear down with sudden increases in activity. It might seem strange to do heavily resisted foot flexion or weighted calf raises, but nothing beats the joy of training without the interruption of injuries.
Treatment and Recovery
If you suspect shin splints, early intervention is crucial. A sports physical therapist can assess movement patterns, identify contributing factors, and design a personalized recovery plan. Here are treatments that the sports PT at Baldi Movement Group recommends:
- Start doing toe taps all day every day: For the anterior tibialis, toe taps (sitting and tapping your foot up and down 20-30 times) is a great low resistance (only against gravity) way of consistently keeping the anterior tibialis warm and healing more quickly. Also begin doing toe taps before any sport activity that involves impact so that the muscles are as warm as possible and will decrease the chance of worsening. For the posterior tibialis, use the same concept but with a very light resistance band for the pointing and inward rotation movement of the foot.
- Use KT tape as needed for support: Kinesio tape (KT tape) is a stretchy tape. It can be applied along the route of an injured muscle in order to assist with the same movement of that muscle. This decreases the work required from the actual muscle and will give it more rest and make it harder to overwork. On each end of the tape use an anchor (1 ½ inches without stretch) so it stays on, and in the middle use a 50% stretch along the length of the muscle. Often two strips is what I start with and adjust as needed.
- Follow the 10 Minute Rule: The 10 Minute Rule can be used to treat ANY muscle or tendon injury. Find an exercise which uses the movement that stresses the injured muscle. Make it hard enough to reproduce pain during the exercise, but easy enough so that the muscle is no worse within 10 minutes. Continue to chase the pain as the muscle heals with progressively higher resistance exercises until the muscle is fully healed and you cannot reproduce pain.
- Single leg strength and stability: This is assessed through various movement screens, and exercises are provided at the appropriate level to help each athlete.
- Gradual Return to Sport: A carefully guided plan to help athletes return to training and competition safely.
Stay Strong and Injury-Free
Shin splints don’t have to sideline athletes for long. With early recognition, smart training habits, and the support of a skilled physical therapist, runners, gymnasts and other athletes can recover fully and reduce their risk of recurrence. Staying consistent with strength, mobility, and recovery strategies is the key to long-term performance and health.
Need expert advice on injury prevention? Contact us today to optimize your training and keep your body performing at its peak!