Not All Shin Splints Are Created Equal

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If you’re a runner, you’ve more than likely experienced shin pain at some point or another. Shin pain can range from relatively minor to quite severe. Like other injury terminology, shin split is a generic and catch-all term that typically refers to any pain in the shin area.

What most people don’t know is that shin splits are not a singular, specific ailment but rather three separate issues.


This is also referred to as exertional compartment syndrome. During exercise, increased blood flow increases the size of the shin muscle (tibialis anterior). However, like all muscles, the tibialis anterior is encased in fascia and can increase in size only so much. This increase in pressure on the fascia is what causes pain. Individuals who have tight fascia surrounding the tibialis anterior are the ones who most often experience exertional compartment syndrome. Typically once one stops running, the pain gradually subsides.


This relates to injury or stress to the bone (tibia). This is commonly referred to as medial tibial stress syndrome (MTSS). However, this term is also used to denote connective tissue/fascia related to shin pain. This typically presents with pain on the inside of the tibia bone.

If the pain is on the front of the tibia (tibial spine), the individual should seek out a physician, as this type of injury is typically classified as more serious.

  • Continuing to run with a shin splint can lead to a stress fracture (small crack in a bone).


Inflammation of the deep fascia surrounding the tibia can result in shin pain. This is often confused with bone pain.


Conservative increases in both speed and distance are two of the best ways to help prevent shin splints. Additionally, performing stability exercises such as balancing on one leg, that stress the muscles to the front and side of the tibia are helpful in preventing shin splints. Lastly, changes in footwear, running gait and changes in biomechanics due to injury can also increase the chance for shin splints.

If you or a running client experiences spin splints, rest and non-impact exercise are advised. If rest does not minimize the shin splints, seeking out a physical therapist is advised.

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