Shin pain often occurs in athletes during or after exercise. Especially when jogging, there is often pulling to stabbing pain in the area of the front or inner shin. The cause is usually overloading or incorrect loading, for example due to incorrect running technique or unsuitable footwear. This can lead to irritation of muscles and tendons as well as periosteitis.
Pain in the shin
In rare cases, however, shin pain can also be a sign of a fatigue fracture or what is known as shin splint syndrome. In the latter, the growth of the muscle caused by exercise leads to constriction of nerves and blood vessels. In the worst case, damage to muscles and nerves can result. Therefore, if you have persistent pain in the shin, you should always consult a doctor and have the cause clarified.
Overuse: common cause of shin pain
Intense training without sufficient rest days or too high a load after a long break from training can quickly lead to pain in the shin in athletes. Running, in particular, puts a lot of strain on the anterior shin muscle. This can result in damage to the muscle fibers or irritation of the tendon insertions. This then manifests itself as pulling or stabbing pain at the front of the shin, which occurs during or after jogging. Likewise, incorrectly fitting or poorly cushioning running shoes can lead to an incorrect load on the muscles and tendons and consequently cause discomfort. The abrupt change of the running surface – for example, from forest soil to asphalt – can also lead to pain in the shin.
Osteomyelitis as a possible consequence
In some cases, overloading can also result in periosteitis. In this case, the constant alternation of tension and stretching of the shin muscle during running leads to friction between the periosteum and the shin bone, which can cause the periosteum to become inflamed in the long term. In this case, the pain is intensified when pressure is applied to the shin bone and subsides when the patient rests. In addition, there is usually swelling in the affected area.
Have fatigue fracture ruled out
Symptoms similar to those of periostitis may also occur with a fatigue fracture (stress fracture) of the tibia. In contrast to a bone fracture caused by trauma, a fatigue fracture manifests itself by pain that begins insidiously with exertion and initially subsides while the patient is still at rest. Later, the symptoms persist permanently and improve only slightly even with rest. A fatigue fracture of the tibia is rare in healthy people and only occurs in cases of severe, permanent overloading. However, there is an increased risk of a fatigue fracture in the case of reduced or pathologically altered bone substance, for example in the case of:
- Osteoporosis
- Permanent intake of cortisone
- Malnutrition or strict diets
- Vitamin D deficiency
- Women in menopause or with disorders of the menstrual cycle.
- Hormonal disorders with an overproduction of parathyroid hormone (hyperparathyroidism).
Shin splint syndrome: danger to muscles and nerves.
Another consequence of unaccustomed, heavy load or excessive training of the lower leg muscles can be the shinbone edge syndrome (tibia edge syndrome). In this case, the increase in volume of the tibial muscle causes pressure to increase in an area of the lower leg delineated by connective tissue sheaths. If muscle growth occurs so rapidly that the connective tissue cannot adapt sufficiently, blood vessels may become constricted. Then the muscle is not adequately supplied with blood and oxygen during exercise, causing pain. Typically, in this syndrome, the pain begins after running about 500 meters and continues after exercise. In advanced stages, the pain usually forces the patient to stop exercising. In shin splints syndrome, the shin bone is usually swollen and hurts when pressure is applied as well as when the foot is lifted toward the knee. In addition, there may be discomfort such as tingling or numbness in the area of the foot.
Treatment absolutely necessary
If shin splint syndrome is not treated, the lack of oxygen supply can lead to the death of muscle fibers or damage to nerves in the worst case.Surgery may then be necessary to relieve the pressure in the tissue. So if you notice symptoms of shin splint syndrome, you should stop your training and see a doctor as soon as possible. In medical circles, shin splint syndrome is also called tibialis anterior syndrome or shin splints and is sometimes used as an umbrella term for stress-related pain in the shin.
Osgood-Schlatter disease: adolescents frequently affected
Behind pain in the area of the upper tibia can also be a so-called Osgood-Schlatter disease. In this disease, bone death occurs in the area of the tibia where the patellar ligament attaches. The exact cause of Osgood-Schlatter’s disease is unclear, but it is possible that overloading the knee through sports or obesity plays a role. Hormonal changes could also contribute to the development of the disease, as adolescents in the growth phase of puberty are often affected.
What to do about pain in the shin?
The first measure for shin pain is to take it easy. Pause with your training for a few days and avoid heavy loads in everyday life. Often cooling and elevating the affected leg already leads to an improvement of the complaints. Loosening massages and light stretching exercises as well as locally acting ointments with the active ingredient diclofenac can also help to relieve the pain. Anti-inflammatory painkillers such as ibuprofen or diclofenac usually work very well against pain – however, they should not be taken for more than a few days.
Shin pain: when to see a doctor?
If the pain does not subside after a few days or keeps recurring, you should have the cause clarified by a doctor. This is especially true if the complaints occur regardless of sports or physical exertion. This is because in very rare cases, a bone tumor or a metastasis in the bone can also be behind the pain in the shin. Shin pain as a result of a fall or an accident is also a case for the doctor, because trauma can cause a fracture or hairline fracture – for example, in the head of the shin bone – under certain circumstances.
Prevent through proper training
Stress-related shin splints can be prevented by proper training. We have compiled five tips for you on how to prevent shin pain:
- Exercise in moderation! Stop when you notice that you come to your load limit and allow yourself regular rest days.
- After a long break from training, you should start slowly to accustom the muscles to the load again.
- Prefer soft ground when running and avoid abrupt changes of the running surface.
- When buying running shoes, have a treadmill analysis to have the shoes individually adapted to your running style. It is better to avoid shoes with spikes – they do not sufficiently cushion the shocks while running.
- If you have malpositions of the feet, it may be useful to have insoles fitted.
