If you run a lot, you’ve probably experienced the agony of shin splints (known to medical professionals as medial tibial stress syndrome).

It’s a pain that seems to come out of nowhere, striking the inner edge of your tibia (the shin bone) and stopping you in your tracks. Here we will discuss the causes of shin splints and the best ways to treat and prevent them.

Why Do I Have Shin Splints?

The pain of shin splints typically strikes at the point where the calf and other muscles are attached to the shin bone, and the usual cause is muscle and bone fatigue due to overwork from repetitive motion.

Shin splints often occur when there has recently been a sudden change in your level of activity—for example, if you have suddenly increased the frequency of your exercise routine from running once a week to running daily; or if you’ve increased the intensity or duration of your workout by suddenly lengthening your runs from half a mile to a mile; or if you’ve switched to a route that takes you up a lot of steep hills.

Runners and dancers are the two groups of people who most frequently suffer shin splints. While activities such as running and dancing can make you particularly susceptible, other factors can also contribute to the problem, such as unusually rigid arches, flat feet, or footwear that is worn out or not designed for rigorous exercise (to ensure that your shoes are appropriate for your running and exercise routine, see our tips for avid runners).

While some details remain unknown about the exact causes of shin splints, the condition can generally be attributed to overuse, which results in the tibia and the muscles attached to it becoming overloaded.

Sudden increases in the frequency or intensity of the stresses placed upon these muscles by running can cause them to become fatigued, rendering them unable to absorb the repetitive shocks to which they are subjected.

The underlying fascia and/or tibia itself is then left to absorb most of this force, and after a while it will begin to hurt. As noted above, the problem can be exacerbated by inappropriate running shoes.

How Are Shin Splints Diagnosed?

Shin splint pain can occur either during or after exercise, and it can be a sharp, stabbing pain or a dull, throbbing ache. In some cases there may be mild swelling, and the pain may be aggravated when you touch the affected area.

If you experience shin splints regularly when you exercise, you should see a doctor as soon as possible.

Your doctor will look over your medical history and give you a thorough physical examination in order to make sure that your pain is not being caused by some other, more serious condition. Shin splints per se are not a serious problem, but there are a number of more serious medical conditions that can cause similar pain, including stress fracture, tendinitis, and chronic exertional compartment syndrome.

Women are almost three times as likely as men to progress to such problems after they have begun to experience shin splints.

How Are Shin Splints Treated?

Because the primary cause of shin splints is overuse, the first and most important prescription is rest. When an attack occurs, sit down as soon as you can, and stay off your feet as much as possible until you can see a doctor—who will probably prescribe more rest.

Put an ice pack on the painful area, and take a couple of ibuprofen pills (Advil or Motrin, for example). Your doctor may recommend a compression bandage for the swelling.

How Can I Prevent Shin Splints?

The best way to prevent shin splints is to take it easy. Don’t be overambitious about stepping up your exercise routine.

Make only gradual increases in the distances you run and the number of days you run each week, and don’t wear yourself out by running too fast. Make sure you are wearing proper running shoes when you run or dance, and make sure that your footwear for other times of day is properly supportive.

Cross training can also be helpful; alternate running with lower-impact activities such as bicycle riding or swimming.

Some people claim that barefoot running, which has gained immense popularity in recent years, prevents injuries such as shin splints by distributing impact more evenly among the muscles of the foot, ankle, and shin.

The evidence for this claim is mixed, however, and there is no scientific consensus on the matter as of this writing; therefore, you should check with your doctor before taking up this practice, and begin gradually as you would with any other change in your fitness regimen.

Questions to Ask Your Doctor About Shin Splints

• What is causing this pain?
• Are my running shoes getting too worn out? How often should I replace them? Do you recommend that I switch to a different brand of shoe?
• How long do recommend I stay off my feet? When can I resume my normal exercise routine?
• Is it likely that I have already caused some permanent injury to my muscles or bones?
• What is your opinion of barefoot running?