“Shin splints,” medial tibial stress syndrome (MTSS), anterior tibialis strain, stress reaction and stress fractures of the bone in your lower leg are all injuries that are VERY closely related, sometimes synonymous to each other and will present with many of the same symptoms. Typically, though, most shin pain can be broken down into two groups: shin splints and stress fractures.
Shin pain most often occurs from overuse but sometimes it can be due to a change in shoes, the surface you are doing activities on and/or a sudden increase in activity. Most people have had “shin splints” before – that aching pain in the front of your leg – especially during and after exercise, but beware of that shin pain because it can progress from a soft tissue injury to causing a stress fracture.
Red flags to be aware of if you are suffering from shin pain that could mean you are developing a stress fracture are: pain that wakes you up at night, pain that started out as diffuse throughout the lower leg and is now in a pin point spot, or the pain you are experiencing is a deep, throbbing pain. The only true way to diagnosis a stress fracture is through a bone scan or MRI.
Some ways to avoid shin pain are to make sure that you slowly increase your activity, increase the flexibility in your calves through stretching, ensure you have a shoe that is appropriate for your foot/activity and try to run on a softer surface to avoid unnecessary impact through the legs.
Runner’s Tip: If you run on roads often, make sure to switch directions! Most roads are crowned which can increase the pronation of the foot on the “high side” of the road, which can lead to shin pain. Make sure sometimes you run with traffic and sometimes against it.
written by Jenn Millen, PTA, ATC