"Shin splints," an overuse injury in which pain is felt over the shin, is a general term used to describe a condition that has a variety of potential causes.  The discomfort can be a result of inflammation of the muscle (tibialis anterior), its tendons, or the periosteum (a membrane that covers bone) of the large bone in the lower leg (tibia).  Inflammation of the bone itself can lead to the pain associated with shin splints as well.  Shin splints are a common obstacle faced by both novice and veteran exercisers.

Symptoms

• pain, dull aching sensation, and/or tenderness along the inner side or front of the shin
• mild swelling 

Causes

• flat feet
• overpronation of feet (excessive rotation of the feet toward the midline of the body)
• improper shoes for exercise mode
• old, worn-out shoes
• increasing volume of exercise too quickly
• running on hard or slanted surfaces
• running down hill

Treatment 

• rest (however, participation in activities that do not aggravate the condition, such as swimming or bicycling, is encouraged to maintain fitness)
• apply ice for 10-20 minutes every two hours to reduce pain and swelling
• apply a compression wrap (ace bandage or sleeve) to control swelling
• non-steroidal anti-inflammatory medication (e.g., ibuprofen)
• doctor may recommend physical therapy (ultrasound, deep massage, and strengthening exercises)

Prevention

• wear orthotic devices to provide arch support or to correct for overpronating
• wear proper shoes for exercise mode (e.g. do not wear yoga shoes to run 5 miles) and ensure shoes provide adequate cushioning
• replace old, worn-out shoes (this would be after about 350-500 miles for runners)
• gradually increase volume of physical activity (do not increase workload by more than 10% per week and avoid increasing the intensity and duration of the exercise in the same session)
• cross-train - alternate days of low impact activity with those of high impact exercise (swim one day, run the next) to reduce the stress placed on the shins
• perform stretching exercises for the calf muscles and the achilles tendon
• perform strengthening exercises for the front lower leg muscles (e.g., toe raises)
• avoid running on hard surfaces (e.g., run on the grass) 

When to Contact your Doctor

• persistent shin pain despite rest and use of ice, compression wraps, and non-steroidal anti-inflammatory medications 
• increased swelling
• shin is hot and inflamed

It is important to contact your doctor if you experience any of the above scenarios because another condition that needs medical attention, such as a stress fracture, may be the cause of the discomfort.

Resources:

www.mayoclinic.com

www.sportsinjuryclinic.com

www.orthoinfo.aaos.org/topic.cfm?topic=A00407