So, your shin hurts.
Shin splints is an umbrella term that encompasses a variety of lower limb injuries. These include medial tibial stress syndrome, stress fractures, chronic exertional compartment syndrome, biomechanical overload syndrome and more.
Irrespective of the above injuries, there is pain felt at some point or another. But, you might be asking yourself, do they feel different? The answer is: yes! How they feel is quite often a quick way to help determine the actual injury behind your pain.
The following are adapted from a clinical article by sports physician Matthew Hislop MD. You can find that article here.
What does MTSS feel like?
How does medial tibial stress syndrome (MTSS) feel?
The most common form of shin splints is often referred to as "posterior tibial stress syndrome." That name, however, is often polarising in the medical community.
MTSS feels like a dull ache or burn in what is referred to as the "distal-third" of your medial tibia. Don't worry - it essentially means the third of the shin bone closest to your foot, on the inside border.
MTSS tends to appear in both legs and is sore to touch for a length of roughly 5cm along the border of your shin bone. Interestingly, the anterior border (outside border) shouldn't be sore to touch.
When you exercise, it tends to hurt during warmup and return at the end of your run.
For more on medial tibial stress syndrome and how to treat it, check out this article.
How does a tibial stress fracture feel?
Runners typically complain of a sudden focal pain on their shin bone that is nasty to touch. This pain also appears early in impact-related exercise and is worse during the landing phase of running.
Typically, a stress fracture is sore to touch and focal, unlike MTSS, which is painful for 5cm or more. It can also occur anywhere on the tibia but is most likely to happen in a similar location to MTSS.
A stress fracture is very painful on impact, so just a single hop on the bad leg tends to warrant enough pain to stop. This injury tends to only appear in 1 leg at a time, but you shouldn't rule out having a fracture in both legs.
These are more severe. If you suspect you have a stress fracture, do not delay seeing a healthcare professional.
For more on tibial stress fractures in runners, check out this article.
What does CECS feel like?
How does chronic exertional compartment syndrome feel?
For this part, we have grouped chronic exertional compartment syndrome (CECS) and biomechanical overload syndrome into one section. Dr Andrew Frankly-Miller, a UK-based Sports and Exercise Physician, developed the latter syndrome to explain the incorrect diagnosis of CECS.
Often the culprit behind "anterior shin splints", CECS feels like a slow build-up of pain as you exercise and a slow decrease in pain when you stop—no sudden changes.
The pain can get pretty intense, and the injury can be handled simply with non-surgical interventions, but in some cases, it requires surgery. This injury can also lead to severe implications, making sure that you consult a doctor or healthcare professional immediately, like any injury on this page.
For more on anterior shin splints, check out this article here.
About the author:
Ben Lindsay is the Managing Director and engineer behind the Solushin medical device. A former national medalist swimmer, Ben aspires to learn from physicians, physiotherapists and podiatrists so he can develop tools to improve the quality of care for their patients.