Shin Splints and Shin Pain in Athletes
Shin pain is one of the most common complaints in running and jumping sports, and one of the most commonly mislabelled. "Shin splints" has become a catch-all for several different problems, and they don't all respond to the same thing.
Sorting out which one you're dealing with matters more than any treatment, because one of them needs to be ruled out before anyone works on it at all.
What Shin Splints Actually Are
The condition properly called shin splints is medial tibial stress syndrome. It's an overload injury where the muscles and connective tissue along the inner shin pull repeatedly on the bone's surface, usually from running on hard surfaces, a jump in training volume, or returning to sport after time off.
The pattern is fairly recognizable. A diffuse ache spread along several inches of the inner shin border, not one spot. Often worst in the first few minutes of activity, easing as the leg warms up, then sore again afterwards and the next morning.
When It Isn't Shin Splints
Two other things present as shin pain, and both change what should happen next.
A tibial stress fracture tends to be focal rather than spread out. You can often put a finger on the sore spot. The pain usually doesn't warm up and go away, it stays or gets worse as you keep going, and it may ache at rest or at night. If that's the pattern, it needs imaging before anyone treats it, because continuing to run on a stress fracture can turn a few weeks of rest into something much longer.
Chronic exertional compartment syndrome has a different signature again. It comes on predictably, at a similar point in every run, with a sense of tightness or fullness in the lower leg. There may be numbness or a foot that feels weak. It settles within minutes of stopping. That one is a medical diagnosis and needs a physician.
If your shin pain looks like either of those, see a doctor first. I'd rather tell you that than take your money for something I can't help.
Why This Shows Up in Young Athletes
Shin splints cluster around change. A new season, a new surface, a growth spurt, a jump from two practices a week to six. The tissue hasn't adapted to the load yet.
Year round single sport play has made this more common than it used to be. A body that never gets an off season never gets the lower load period where this kind of thing used to settle on its own.
Growth matters too. A teenager who has grown several inches in a year is running on leverage they haven't calibrated to, with muscle and connective tissue that lengthened faster than it adapted.
What I Do For It
Once a stress fracture has been ruled out, shin splints respond well to hands-on work. What I'm treating is the soft tissue that's pulling on the bone: the deep calf, tibialis posterior, soleus, and the connective tissue along the inner shin.
I use a combination of myofascial therapy, Fascial Counterstrain, and acupuncture, based on what the leg actually needs. Fascial Counterstrain is useful here because it's low force, which matters when the area is already irritated and direct pressure tends to make it worse.
Most athletes I see for this have already tried rest, ice and stretching, and found it comes back when they return to play. That's usually because the tissue restriction driving it was never addressed.
What I Don't Do
I don't do foot work, and shin pain is sometimes driven by foot mechanics. If your arch, gait or footwear is a significant part of the problem, you'll want someone who handles that. I'd rather say so than treat around it and have the problem come back.
I also won't tell you when it's safe to return to play. That's for your physician or athletic trainer.
Common Questions
How do I know if it's shin splints or a stress fracture?
The general pattern is that shin splints ache diffusely along several inches of the inner shin and often ease once you're warmed up, while a stress fracture tends to be tender in one specific spot and doesn't ease with activity. That's a guide, not a diagnosis. If the pain is focal, or if it hurts at rest or at night, get it imaged before continuing to train on it.
Can acupuncture help shin splints?
It can be part of what helps, usually alongside hands-on work rather than on its own. What I'm addressing is the soft tissue along the inner shin and deep calf that's pulling on the bone. Patients often notice the morning soreness settles first.
Do I have to stop running?
That depends on what's actually going on, which is why the first question matters. For true shin splints, a reduction in load usually beats complete rest. For a suspected stress fracture, that's a conversation with your physician, not with me.
Why does it keep coming back?
Usually because the rest resolved the symptom without changing what caused it. If the tissue restriction and the load pattern are both still there, returning to full training tends to bring it back within a few weeks.
How long does treatment take?
Recent cases often respond in a handful of sessions. Something that's been recurring for a season or more usually takes longer. I'll tell you what I think after the first visit.
Book an Appointment
Berkley Acupuncture
36700 Woodward Ave, Suite 30
Bloomfield Hills, MI 48304
(248) 210-1895
Serving high school and college athletes across the Detroit Metro area including Bloomfield Hills, Birmingham, Royal Oak, Berkley, Beverly Hills, Franklin, Troy and Bloomfield Township.