Shin Pain

Shin Pain

The lower leg is comprised of two major bones; the tibia and the fibula. The connect to the upper thigh bone, femur, and the ankle by ligaments. The tibia is commonly known as the shin bone and is the weight bearing bone in the lower leg. The fibula is located on the outside of the leg and doesn’t actually have any weight placed on it while walking.

The tibia and fibula are connected to the femur, thigh bone, by the knee ligaments.

  1. 1. MCL (Medical Collateral Ligament)
  2. 2. LCL (Lateral Collateral Ligament)
  3. 3. PCL (Posterior Collateral Ligament)
  4. 4. ACL (Anterior Collateral Ligmanet)

The tibia and fibula are connected to the ankle by the ankle ligaments.

Ligaments on the outside of the angle.

The major ligaments in the ankle that are most commonly sprained are located on the outside of the ankle. These are sprained with “inversion sprains)

  • Anterior Talofibular Ligament
  • Calcaneofibular Ligament
  • Posterior Talofibular Ligament
  • Deltoid Ligament

Ligaments on the inside of the ankle. This is sprained with “eversion sprains”.

The muscles of the lower leg are classified by departments: the posterior, anterior and lateral compartments.

Posterior Compartment (3 muscles)
These muscles form the achilles tendon. The more flexible and strong these muscles are, the less prone you are to achilles tendon injuries, ankle sprains and plantarfascitis.

This is what we all call our “calf muscle”. It is the largest and strongest of the lower leg muscles. This muscle is most active when the leg is straight helping to point the ankle and bend the knee.

Plantaris (below the Gastrocnemius)
This muscle is absent in about 10-15% of the population.

Helps point the foot when the knee is bent.

Tibialis Posterior
This is helps support the arch of the foot. Commonly involved in shin splints.

Flexor Digitorum Longus
Curls the toes of the foot and helps point the foot

Flexor Hallucis Longus
This is the muscle of the big toe; it helps to curl it. It also helps point the ankle and turn the ankle inward.

Lateral Compartment (2 muscles)
These muscles help pull the ankle outward. These are important in stabilizing the ankle and play a key role in the rehabilitation of an ankle sprain. If a person sprains their ankle and stretches out the ligaments; these muscles will aid in better stabilizing the ankle.

  • Peroneus Longus
  • Peroneus Brevis

Anterior Compartment (4 muscles)

Tibialis Anterior
This helps to pick up the foot. This often becomes weak in older people as they become less active. As the muscles gets weak, it is harder to pick up the foot so that the toes can clear the ground when walking leading to a higher risk of falls.

Extensor Digitorum Longus
This muscles helps to lift up or extend the toes

Extensor Digitorum Hallucis
This muscle lifts or extends the big toe.

Peroneus Tertius

The term “shin splints” refers to pain along the shinbone (tibia) — the large bone in the front of your lower leg. Shin splints are common in runners, dancers and military recruits.

Medically known as medial tibial stress syndrome, shin splints often occur in athletes who have recently intensified or changed their training routines. The muscles, tendons and bone tissue become overworked by the increased activity.

Most cases of shin splints can be treated with rest, ice and other self-care measures. Wearing proper footwear and modifying your exercise routine can help prevent shin splints from recurring.


If you have shin splints, you may notice:

  • Tenderness, soreness or pain along the inner part of your lower leg
  • Mild swelling in your lower leg

At first, the pain may stop when you stop running or exercising. Eventually, however, the pain may be continuous.

When to see your Therapist

Consult your doctor if rest, ice and over-the-counter pain relievers don’t ease your shin pain.


Shin splints are caused by repetitive stress on the shinbone and the connective tissues that

attach your muscles to the bone.

Risk factors

You’re more at risk of shin splints if:

  • You’re a runner, especially just beginning a running program
  • You play sports on hard surfaces, with sudden stops and starts
  • You run on uneven terrain, such as hills
  • You’re in military training
  • You have flat feet or high arches

Tests and diagnosis

Shin splints are usually diagnosed based on your medical history and a physical exam. In some

cases, an X-ray or other imaging studies can help identify other possible causes for your pain,

such as a stress fracture.

Treatments and drugs

In most cases, you can treat shin splints with simple self-care steps:

  • Rest. Avoid activities that cause pain, swelling or discomfort — but don’t give up all physical activity. While you’re healing, try low-impact exercises, such as swimming, bicycling or water running.
  • Ice the affected area. Apply ice packs to the affected shin for 15 to 20 minutes at a time, four to eight times a day for several days. To protect your skin, wrap the ice packs in a thin towel.
  • Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others) to reduce pain.
  • Resume your usual activities gradually. If your shin isn’t completely healed, returning to your usual activities may cause continued pain.


To help prevent shin splints:

  • Choose the right shoes. Wear footwear that suits your sport. If you’re a runner, replace your shoes about every 350 to 500 miles (560 to 800 kilometers).
  • Consider arch supports. Arch supports can help prevent the pain of shin splints, especially if you have flat arches.
  • Lessen the impact. Cross-train with a sport that places less impact on your shins, such as swimming, walking or biking. Remember to start new activities slowly. Increase time and intensity gradually.
  • Add strength training to your workout. To strengthen your calf muscles, try toe raises.
  • Stand up. Slowly rise up on your toes, then slowly lower your heels to the floor. Repeat 10 times. When this becomes easy, do the exercise holding progressively heavier weights. Leg presses and other exercises for your lower legs can be helpful, too. 

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