Guest Article: Four Types of Shin Splints and Their Causes

Today’s guest arti­cle has been gen­er­ous­ly con­tributed by Chris Mal­lac, a phys­io­ther­a­pist and top sports train­er from the UK.  He invites you to CLICK HERE to sub­scribe to his newslet­ter, packed with addi­tion­al use­ful infor­ma­tion for any­one who wants to sus­tain a high lev­el of phys­i­cal activ­i­ty or involve­ment with sports.

4 types of shin splints and their caus­es

The great thing about French Rug­by teams is that they usu­al­ly play in sta­di­ums that are munic­i­pal­i­ty owned venues that more often than not have a tar­tan run­ning track around them.

The club I am cur­rent­ly with in the south of France had their sta­di­um built for the USA Track and Field team in prepa­ra­tion for the Barcelona Olympics. To be run­ning on the same track that Den­nis Mitchell, Carl Lewis, Michael John­son, Gail Dev­ers and Eve­lyn Ash­ford ran on is a bit of a buzz.But sur­pris­ing­ly the tar­tan is also killing my shins.

It is not the tar­tan that is the prob­lem, it is more my behav­iour. Being on a tar­tan track is very moti­va­tion­al for pump­ing out repeat speed efforts. And this is what is killing my calves and shins. It is the vol­ume of run­ning and the speed at which I am doing it. So I am suf­fer­ing from gar­den vari­ety shin splints at the moment.

Shin splints can be bro­ken down into a num­ber of types. These are list­ed and explained as fol­lows;


  • Medi­al tib­ial stress syn­drome (perios­ti­tis). This is an irri­ta­tion of the mus­cle attach­ments that orig­i­nate on the medi­al shin and pass down­wards into the arch of the foot. Mus­cles such as soleus, tib­ialis pos­te­ri­or and flex­or hal­lu­cis longus have been impli­cat­ed in this type of shin splint. The pain is usu­al­ly wide­spread along the dis­tal third of the medi­al tib­ia.
  • Stress frac­tures. Usu­al­ly found in the tib­ia, these stress frac­tures can be very painful to touch (excru­ci­at­ing point ten­der­ness) and may get night pain or rest­ing pain. These may often be the end result of medi­al tib­ial stress syn­dromes if the run­ner ignores the pain and con­tin­ues to push through. A bone over­load devel­ops and a stress frac­ture may result.
  • Tib­ialis Ante­ri­or mus­cle trig­ger points. This is char­ac­terised by pain at the very front of the shin through the tib­ialis ante­ri­or. Usu­al­ly caused by high vol­umes of down­hill run­ning where the eccen­tric con­trol of dor­si­flex­ion is required.
  • Com­part­ment syn­dromes. The calf and shin mus­cles are enveloped into four sep­a­rate mus­cle com­part­ments. A com­part­ment syn­drome devel­ops due to growth of the mus­cles with­in the com­part­ment with­out a sub­se­quent stretch­ing of the envelop­ing fas­cia. A deep tight ache is felt the fur­ther the per­son runs due to blood flow con­stric­tion and nerve com­pres­sion. They may feel some numb­ness and tin­gling into the feet.

The cause of any of these prob­lems can usu­al­ly bro­ken down into the fol­low­ing;

  1. Bio­me­chan­i­cal faults. Things such as over­prona­tion, tight­ness in the calf mus­cles, weak anti-prona­tion mus­cles are exam­ples of such caus­es.
  2. Envi­ron­ment. The sur­face the run­ner runs on and sud­den changes in the sur­face. Run­ning on unfor­giv­ing con­crete sur­faces usu­al­ly required a greater absorp­tion of shock in the mus­cles and bones of the shin. This may then set off a shin splint type prob­lem.
  3. Equip­ment. Run­ning in the wrong shoes or with­out orthot­ic sup­port if required. These will both change the mus­cle recruit­ment and absorp­tion forces across these mus­cles.
  4. Train­ing. Sud­den increas­es in vol­ume and/or inten­si­ty may also set off a shin splint type prob­lem.

There­fore man­age­ment of the var­i­ous “shin splint” vari­eties is based on elim­i­nat­ing the caus­es and not on any recipe treat­ment. In my case, I need to mod­i­fy the load and not go so hard for so long, but have a more grad­ual build up.

For some­one else their cause may lie else­where and they may need cor­rec­tion of their over-prona­tion, or mas­sage of their tight myofas­cial calf struc­tures, or strength­en­ing of their hip rota­tors and pelvic sta­bilis­ers. For oth­ers they may just need good advice on wear­ing the right run­ning shoes.


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Chris Mallac’s newslet­ter The Sports Injury Doc­tor


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website,, provides more information about his approach.

Please contact him at or at 212-400-9663.

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