Alternate Names: Lower leg pain; Pain - shins; Anterior tibia pain

Considerations: Shin splints may be any of 4 types of problems, none of which are serious. All types of shin splints can be resolved with rest.

Common Causes: Posterior tibial shin splints, in the front portion of the legs, account for about 75% of the problems affecting athletes.

Tibial periostitis occurs further toward the front of the leg than posterior tibial shin splints, and the bone itself is tender.

Anterior compartment syndrome affects the outer side of the front of the leg.

Stress fracture is usually a localized, sharp pain with tenderness 1 or 2 inches below the knee. This condition is likely to occur 2 or 3 weeks into a new training program after the legs have taken a real pounding.

Home Care: For posterior tibial and tibial periostitis shin splints, the healing process usually takes a week of rest with ice treatment for 20 minutes twice a day. Over-the-counter pain medications will also help. Running should not begin again for another 2 to 4 weeks.

For anterior compartment syndrome, pain will usually subside as the muscles gradually accustom themselves to the vigorous exercise. Complete rest is probably not necessary.

For a stress fracture, rest for at least 1 month is required. Complete healing requires 4 to 6 weeks. Crutches can be used but typically are not necessary.

Call If:

• the pain is prolonged and persistent even with rest.
• the diagnosis is not definitive or if there is no progress with home treatment after several weeks.

What To Expect: The medical history will be obtained and a physical examination performed.

Medical history questions documenting your symptom in detail may include:

• time pattern
  • When did the pain develop?
  • Is it present all of the time?
• quality
  • Describe the pain.
  • Is it a sharp pain?
• location
  • Are both legs affected?
  • Where exactly on the leg is the pain?
• aggravating factors
  • Have you recently begun exercising?
  • Have you recently increased the amount that you exercise?
  • Have you recently changed the type of exercise that you do?
• relieving factors
  • What have you done for the pain?
  • How well did it work?
• other
  • What other symptoms are also present?