Shin Splints in Kids: What Are They and How to Prevent them

Medial tibial stress syndrome – or “shin splints” as they are commonly called – is an overuse injury that causes pain and tenderness along the middle part of the tibia, the larger of the two bones in the lower leg. Pain is typically located in the middle-to-lower third of the shin.

Naomi Brown, MD, FAAP, CAQSM, a pediatric sports medicine physician at Children’s Hospital of Philadelphia (CHOP) who specializes in sports injury prevention and overuse injuries, answers some frequently asked questions about shin splints in kids and how best to avoid them.

What are shin splints in kids? 

Shin splints are a common cause of leg pain in physically active kids, teens and adults who engage in repetitive, high-impact exercises such as running, tennis, soccer, basketball and dance. They’re one of the most common overuse injuries any athlete can experience but are more commonly seen in females who typically have less muscle mass around the shin bone.

Shin splints in young athletes can be inconvenient and frustrating. They often are relatively harmless and occur without a specific injury or severe pain but can be hard to shake without proper rest. Pain typically starts early during the activity – may seem to lessen during continued activity – yet persists after stopping the activity due to inflammation of the muscles and tissues surrounding the tibia. Generally, the pain will subside with proper rest and treatment.

What causes shin splints in kids?  

Shin splints are often linked to a combination of external and internal factors, including:

• Excessive running or a sudden increase in running mileage
• Changes in the running or playing surface (i.e. concrete, grass, track, turf)
• Changes in footwear (i.e. new shoes or exercising in old footwear)
• The biomechanics of your child’s body which may cause:
  • Hip or core weakness
  • Lack of flexibility
  • Weakness in lower leg or foot muscles
  • Flat feet

Other risk factors for shin splints include having a previous running injury and being overweight. Genetic factors can increase a person’s risk of developing shin splints. 

How can you prevent shin splints in kids?  

While some factors causing shin splints in young athletes may be unavoidable – such as a genetic predisposition of muscle weakness in the lower leg – there are some ways you can lower your child’s risk. Once the pain has resolved, the key to preventing future shin splints is to figure out what caused the condition in the first place and focus on tackling them at the source.

• Focus on keeping good ankle flexibility, foot, ankle, hip and core strength.
• See a physical therapist (PT) to address any mechanical deficits contributing to the increased stress at the tibia. A PT can also perform a running assessment to see if the way your child runs is putting increased stress on their shins. Running on harder surfaces (such as concrete) increases the stress seen at the shins, compared to running on treadmill, track or trail. For more information, visit CHOP’s Running Medicine and Performance Clinic.
• Check your shoes. Running in old sneakers or sneakers that have more than 300 miles on them increases the risk of shin splints. Make sure shoes have enough support for the foot type and use shock-absorbing insoles. Adding an over-the-counter semi-rigid arch support may help to improve symptoms as well.
• Slowly increase the intensity, duration and speed of the training routine. When increasing mileage running, a good rule of thumb is to not increase the mileage by more than 10% per week to allow the muscles to adjust to the increase in training.
• Don’t run every day. Mix up your routine by cross-training and be sure to take a break from running 1 or 2 days a week.
• Take time to recover after an injury; going back to 100% effort after a shin splint increases the chance of reinjury.
• Stretch before and after exercise to keep muscles limber. This too can help avoid recurring shin splints.

Treating shin splints in kids 

Often, shin splints in young athletes will heal with treatments that can be done at home – starting with rest. Rest is critical to reduce the stress on the muscles and bones. Athletes can cross-train – using an elliptical, stationary bike or swimming – while resting from high impact activities. This allows athletes to decrease the stress on the shins but allows them to continue conditioning. It’s important to stress to young athletes that they must use pain as their guide to allow the shins to heal. Encourage them to listen to their bodies and rest, apply ice packs and/or use over-the-counter pain medication when pain increases. Stretching and strengthening exercises can help improve symptoms and get athletes back in action. A pediatric sports medicine specialist or physical therapist can help with specific shin splint stretches and other exercises for shin splints to help prevent these unwelcome overuse injuries from recurring throughout the season or every time you start up a new training routine.