Understanding Shin Splints
Shin splints, medically known as Medial Tibial Stress Syndrome (MTSS), are one of the most common causes of lower leg pain in runners, athletes, military recruits, and individuals who suddenly increase their level of physical activity.
The pain typically develops along the inside (medial border) of the shin bone (tibia) and is caused by repetitive stress placed on the muscles, tendons, and connective tissues that attach to the bone. Fortunately, most cases respond well to conservative treatment when addressed early.

What Are Shin Splints?
Shin splints occur when repetitive stress causes irritation and inflammation where the muscles attach to the tibia (shin bone). This overuse injury commonly develops when the lower leg is unable to adapt to increased physical demands.
Patients often describe:
• Pain along the inside of the shin
• Tenderness to the touch
• Pain that begins during or after exercise
• Mild swelling in the affected area
• Symptoms that improve with rest but return during activity
If left untreated, continued stress may increase the risk of developing a stress reaction or stress fracture of the tibia.

What Causes Shin Splints?
Several factors can contribute to the development of shin splints, including:
Overuse
Rapid increases in:
• Running mileage
• Exercise intensity
• Training frequency
• Jumping or high-impact activities.

Improper Foot Mechanics
Certain foot types place additional stress on the muscles that support the arch and tibia.
Common biomechanical factors include:
• Flat feet (overpronation)
• High arches
• Poor running mechanics
• Muscle imbalances

Inadequate Footwear
Worn-out or unsupportive shoes fail to properly absorb impact and may increase stress on the lower leg.

Tight Muscles
Tight calf muscles, Achilles tendons, and hamstrings can alter lower extremity mechanics and increase tension along the shin.

Hard Running Surfaces
Frequent training on concrete or other hard surfaces increases repetitive impact forces.

Conservative Treatment
The majority of patients improve without surgery. Treatment focuses on reducing inflammation, allowing the injured tissues to heal, and correcting the underlying cause of the problem.

Rest and Activity Modification
Reducing or temporarily stopping painful activities allows the irritated tissues to recover. Low-impact exercises such as swimming or cycling may be recommended during the healing process.

Ice Therapy
Applying ice to the painful area for 15–20 minutes several times daily can help reduce inflammation and relieve discomfort, particularly after activity.

Anti-Inflammatory Medications (NSAIDs)
When appropriate, over-the-counter nonsteroidal anti-inflammatory medications such as ibuprofen or naproxen may help reduce pain and inflammation. These medications should be used only as directed and may not be appropriate for every patient.

Proper Shoe Gear
Supportive athletic shoes that match your foot type and activity level play an important role in both treatment and prevention.
We recommend:
• Replacing running shoes every 300–500 miles
• Wearing activity-specific footwear
• Avoiding excessively worn shoes
• Choosing shoes with appropriate cushioning and stability.

Custom Functional Orthotics
For many patients, abnormal foot mechanics are a significant contributor to shin splints.
Custom orthotics are designed to:
• Improve foot alignment
• Reduce excessive pronation
• Decrease stress on the tibia and supporting muscles
• Improve shock absorption
• Help prevent recurrent injuries
Because they are customized specifically for your feet, prescription orthotics often provide superior support compared with over-the-counter inserts.

Radial Shockwave Therapy (EPAT)
For patients with persistent shin splints that have not responded to traditional conservative care, Extracorporeal Pulse Activation Technology (EPAT®), also known as Radial Shockwave Therapy, may provide an effective non-surgical treatment option.
EPAT uses high-energy acoustic pressure waves that stimulate the body's natural healing response within injured tissues.
Potential benefits include:
• Increased blood flow to the injured area
• Stimulation of tissue repair
• Reduction of chronic inflammation
• Improved healing of damaged soft tissues
• Decreased pain
• Faster return to activity.
Treatment is performed in the office without surgery or injections. Most patients require a series of treatment sessions, each lasting approximately 10–15 minutes. Because there is little to no downtime, patients can typically resume normal daily activities shortly after each visit.
Your podiatrist will determine whether EPAT therapy is appropriate based on your symptoms, physical examination, and imaging studies if necessary.

When Should You See a Podiatrist?
You should schedule an evaluation if:
• Pain persists despite rest
• Pain worsens during walking or daily activities
• Symptoms continue for several weeks
• You notice swelling that does not improve
• You experience pinpoint pain that could indicate a stress fracture
• Shin pain repeatedly returns when you resume exercise.
Early evaluation helps distinguish shin splints from stress fractures, tendon injuries, compartment syndrome, and other conditions that may require different treatment.

Get Back to Doing What You Love
Shin splints are one of the most common overuse injuries affecting active individuals, but they are highly treatable. With early diagnosis, proper footwear, custom orthotics when indicated, activity modification, and advanced therapies such as EPAT, most patients can safely return to running, sports, and everyday activities.
If you're experiencing persistent shin pain, schedule an evaluation with our office. We'll identify the underlying cause of your symptoms and develop a personalized treatment plan to get you back on your feet as quickly and safely as possible.