The fibula and the tibia are the two bones in the lower leg, both of which have muscles attached to them that help to move the feet.
The exact cause of medial tibial stress syndrome (shin splints) has not been confirmed. However, high impact activities such as running on concrete or other hard surfaces can contribute to their development. Other risk factors may include:
- Over-training (e.g. training beyond your fitness level).
- Increasing the intensity, duration or frequency of training too quickly.
- Running on sloping ground.
- Wearing poorly fitting or inappropriate running shoes.
- Poor running technique.
- Having flat feet or increased foot pronation (i.e. feet that roll inwards).
- Imbalances in the strength of the different muscles of the lower leg.
- Previous injury.
The pain of shin splints may be caused by the muscles and tendons of the leg causing inflammation by tugging on the bone, or may be due to a stress reaction from the bones themselves. For example, repetitive trauma to the tibia (which may be caused by the heel repeatedly landing on a hard surface) may interfere with the bone’s ability to re-model and repair itself.
Inadequate calcium consumption has also been proposed as a contributing factor to shin splints, and being overweight (having a high body mass index) may increase the risk.