When Shin Splints Aren't "Just Shin Splints"

Most runners have heard of shin splints, if not experienced them. They're one of the most common injuries, especially for new runners. But what exactly are shin splints? And when are they more than "just shin splints?" Let's take a closer look.

What Are Shin Splints?

The term "shin splints" encompasses two different medical diagnoses—anterior tibial stress syndrome and medial tibial stress syndrome. If shin splints progress and worsen, they can occasionally develop into tibial stress fractures, which are a much more serious condition. In each case, pain is focused on or around the tibia, also known as the shinbone.

In both anterior and medial tibial stress syndrome, this pain is caused by inflammation of the muscles and tendons of the lower leg, as well as the outer layer of bone of the shinbone, called the periosteum. A stress fracture, the most serious condition of the tibia, is physical damage to the shin bone itself.

Shin splints are most often caused by overuse, especially from high-impact activities like running. Wearing ill-fitting or worn-out shoes, running on hard or uneven surfaces, having flat feet or suddenly increasing how fast or far you run can all make shin splints more likely.

The Symptoms of Shin Splints

Pain along the shinbone or in the lower front part of your leg is the primary symptom of shin splints. This pain can feel dull, sharp or throbbing and can range from mild to severe. It's most likely to hurt during or immediately after activity. Shin splints can also present mild swelling and tenderness to touch.

Each of the three types of conditions present differently:

Anterior Tibial Stress Syndrome Symptoms and Causes

Pain from anterior shin splints exists primarily along the exterior edge of the shin, towards the outside of your leg. This type of shin splint is basically caused by overuse of the tibialis anterior muscle, which helps flex your foot upwards. This most often happens to new runners, or those running hills or stairs.

Medial Tibial Stress Syndrome Symptoms and Causes

Medial tibial stress syndrome is felt mostly along the lower inside edge of the shin, towards your calf or the back of your ankle. Like anterior tibial stress syndrome, this is also an inflammation of muscle and soft tissue caused by overuse or stress. The difference is that this version of shin splints comes from overusing the muscles and tendons responsible for flexing your feet down or pointing your toes, rather than raising them.

Tibial Stress Fracture Symptoms and Causes

A stress fracture is the most serious of the three conditions being discussed. It means there are microscopic cracks developing within the bone itself. If left untreated, these cracks are likely to grow larger and can eventually turn into a full-on break in the tibia.

Tibial stress fractures present as an aching or throbbing pain in the shin bone itself and will typically get worse over time. During an exam, a patient will have a more defined area on the actual bone that is very tender to touch. Unlike the two forms of shin splints, stress fracture pain is most severe on the shinbone itself, rather than the soft tissue, and is often pinpointed to a small, specific area.

Treating Shin Splints at Home

Runners are used to pushing through various aches and pains, but shin splints shouldn't be ignored. It's better to take a few weeks to recover early than to spend months sidelined. Pushing through can many times make your symptoms worse, leading to a stress fracture that could require more extensive treatment, sometimes even surgery! Here are some options for treating your shin splints at home:

Rest

First and foremost, give your bones and ligaments time to recover. Sometimes simply taking a break from running and other high-impact activities can be enough to put an end to your shin splints. This can also give your body an opportunity to adapt to the stress and stimulus that caused shin splints in the first place, meaning that once you've had time to heal, the shin splints won't come back. You can stay active with low-impact exercise, like swimming, cycling or the elliptical.

Pain Relievers and NSAIDS

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and reduce swelling from shin splints. There are plenty of options here, so it may be helpful to discuss the best choice for you with your doctor or pharmacist.

Ice

Ice is a great way to reduce pain and swelling from shin splints. Never apply ice or ice packs directly to the skin, as this can effectively lead to frostbite; wrap them in a towel or cloth first and limit your icing sessions to 20 minutes or less. Wetting the cloth first can make icing more effective.

Stretching

Doing stretches for your lower calves, hamstrings, feet and ankles can help alleviate the pain of shin splints. But we recommended that you first speak to a physical therapist or orthopedic specialist, as the wrong kinds of stretches can actually make your symptoms worse!

When to See a Doctor

With proper care and load management, most people recover from minor shin splints in two to six weeks. Stress fractures can require six to eight weeks of avoiding high-impact activities, and in severe cases can take up to six months to make a full recovery. Give yourself at least two weeks without pain or other symptoms before resuming your usual activities and remember to ramp up gradually rather than return all at once.

If you're trying at-home recovery methods like rest and ice but the pain persists beyond these timelines, it's time to schedule an appointment with a sports medicine specialist. Remember—shin splints can start as relatively minor issues but sometimes progress into a surgery-requiring fracture of the leg.

Don't let shin splints slow you down. Visit resurgens.com today to schedule an appointment with an orthopedic specialist near you.

Resurgens Orthopaedics is the title sponsor of Atlanta Track Club and Atlanta Beltline's "Race the Loop" series. The next race in the series is the Westside Beltline 10K-3K on Feb. 7, 2026, followed by the Northside Beltline 5K-3K on April 18, Southside Beltline 8K-3K on Aug. 1, and Eastside Beltline 12K-3K on Dec. 5. To learn more about the Race the Loop Series and register for events, visit https://www.atlantatrackclub.org/beltline-race-series.