Shin Splints | Diagnosis & Treatments

How do we diagnose shin splints?

We know that the first step to treating your child is forming an accurate, timely diagnosis. To diagnose shin splints, your child’s orthopedic specialist will take a medical history and perform a physical exam on your child.

The doctor will also get x-rays to make sure there isn’t a true fracture. But because children can have stress fractures and damage to their growth plates that can’t be seen on x-rays, the clinician may use MRI (magnetic resonance imaging) and, rarely, a bone scan to get detailed images of the injury and verify that there is — or isn’t — a fracture.

How do we treat shin splints?

Boston Children's Hospital's Orthopedic Center provides patients with comprehensive care — including evaluation, diagnosis, consultation, non-surgical therapies, surgery, and follow-up care.

Initial first aid for shin splints usually involves “R.I.C.E.” (rest, ice, compression, and elevation), as well as medications to help control pain and swelling:

  • Rest: Make sure your child doesn't exert in any way that involves the injured area; he can use crutches or a cane, if it helps.
  • Ice: Wrap a towel around ice cubes, or use a bag of frozen vegetables, to ice the area at two-hour intervals, for 20 minutes each time.
  • Compression: Wrap a bandage or soft brace (from the drugstore) around his injury.
  • Elevation: The child should remain seated or reclining, with his leg elevated, as often as possible before seeing the doctor.

The primary therapy for most cases of shin splints is simply to rest the injured leg — restricting all activities that involve using the leg for a period of weeks or months. Your child's doctor may also recommend a cast or walking boot in order to:

  • relax the stress on the leg
  • protect the leg from further damage
  • force the athlete to rest

For an unusually severe overuse injury, treatment options may include:

  • temporary use of crutches or a wheelchair
  • physical therapy to stretch and strengthen the injured muscles and tendons
  • (very rarely) surgery or cauterization

Caring for your child as he heals

Your child's doctor will give you guidance regarding:

  • how long your child's leg should be rested in order for it to heal
  • tools for getting the injured leg back in shape, such as massage, stretching exercises, and strength training

Most kids with shin splints can return to sports and regular activities after several weeks or months of rest and healing time. But during the healing period, it's important for everybody in the family to support the young athlete's resolve to rest the healing area, since he may feel disappointed and even a bit depressed at not being able to run or play his sport.

How can parents and coaches help kids avoid shin splints and other overuse injuries?

Parents and coaches have a great deal of influence — for better or for worse. Parents and coaches should stress moderation in training and should restrain the zeal with which they push youth and teens.

Coaches themselves should learn and use proper training techniques, and should avoid too many repetitive drills, since these are the overwhelming reason for overuse injuries. Coaches should also teach proper running mechanics and other sport-specific motion techniques.

Physical education departments should make sure that the surfaces of a track or field are in good shape, and that proper equipment, footwear, and protective gear are used for each sport.

Our orthopedic specialists advise:

  • warming up and stretching before practice
  • resting at least one day a week
  • cross-training/alternating sports: It is usually unwise for a child or teen to specialize in just one sport. Multi-sport athletes tend to get fewer overuse injuries than those who specialize in just one sport.
  • alternating exercises during practice: Not only is the athlete less likely to experience an injury — studies have also shown that over the long term, muscle memory actually improves if one varies the drills.

Are there other guidelines and resources for injury prevention and safer training?

The American Academy of Orthopaedic Surgeons (AAOS) has issued comprehensive guidelines for helping to prevent sports injuries. Below is an excerpt from the AAOS recommendations:

  • use proper equipment
  • warm up
  • stretch
  • drink water
    • Drink enough water to prevent dehydration, heat exhaustion, and heat stroke.
    • Drink 16 ounces (one pint) of water 15 minutes before exercising and another 16 ounces after cool-down.
    • Drink water every 20 minutes or so while exercising.
  • cool down
    • Cool down for twice as long as warm-up.
    • Slow down motion and lessen intensity for at least 10 minutes before stopping completely.
  • rest
    • Schedule regular days off from exercise, and rest when tired.
    • Fatigue, soreness, and pain are good reasons to not exercise.

Coping and support

At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's — and your own — hospital experience as pleasant as possible. The Hale Family Center for Families staff will give you all the information you need regarding:

In particular, we understand that you may have a lot of questions when your child is diagnosed with shin splints. Will this affect my child long term? When can he return to his sports and activities? We can connect you with extensive resources to help you and your family through this stressful time, including:

  • patient education: From the first doctor's appointment to treatment and recovery, our staff will be on hand to walk you through your child's treatment and help answer questions you may have — How long will his recovery take? Will he need home exercises and physical therapy? We'll help you coordinate and continue the care and support your child received while at Boston Children's.
  • parent-to-parent: Want to talk with someone whose child has been treated for shin splints? We can often put you in touch with other families who've been through the same process that you and your child are facing, and who will share with you their experience.
  • faith-based support: If you're in need of spiritual support, we'll connect you with the Boston Children's chaplaincy. Our program includes nearly a dozen clergy — representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian, and United Church of Christ traditions, among others — who will listen to you, pray with you, and help you observe your own faith practices during your experience.
  • social work: Our clinical social workers have helped many families in your situation. Your Boston Children's social worker can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to dealing with a child's injury, changing family dynamics, and financial issues.