Leg Pain? Must Be Shin Splints!

By May 5, 2013Pain Info, Blog

Written by Arny Warkentin

In this post I will explore another common cause shin splints in the lower leg. As I mentioned in the previous post the term shin splints is often used as a catch-all for lower leg pain, often the diagnosis says little about what is actually going on and what to do about it.

In this post I will focus on periostitis, explaining what it is and what can be done about it.

Periostitis is defined as “inflammation of the periosteum. This inflammation develops at the insertion of the leg muscles on the tibia.” Periosteum is a layer of dense irregular connective tissue which covers all bones completely, except for at joints.

Why Does the Periosteum Become Inflamed?

All muscles attach to bones via this periosteum, and when a muscle pulls on its attachment site beyond what it is capable of recovering from then inflammation occurs.

What Causes Periostitis?

Overuse is the most common cause of periostitis, which can be due to overtraining, improper technique, improper footwear, or poor biomechanics.

Symptoms of Periostitis

  • Excessive pronation of the foot (collapsing of the arch)
  • Pain in the posteromedial border of the tibia (on the inside border of the shin bone)
  • Achiness worse in the morning and with commencing exercise
  • Pain gets better after warm-up, coming back towards end of exercise and afterwards

What Can Massage Therapy Do To Help?

After assessing and locating the precise area involved massage therapist are able to break down adhesions built up from the repeated strain, correct hypo-mobile tissues and structures, strengthen weakened muscles, and correct poor biomechanics.

These goals can be achieved through the use of:

  • Joint mobilizations
  • Proprioceptive neuromuscular facilitation
  • Active and passive stretching
  • Home-care exercise instruction
  • Myofascial release techniques
  • Cross-fibre frictions


Overuse of specific musculature, whether from overtraining or poor biomechanics, leads to excessive strain to the periosteum (covering of bones) which leads to specific, localized pain in the inner border of the shin bone upon waking, while starting exercise, and towards the end and after exercise.

Rattray, F., Ludwig, L. (2000). Clinical Massage Therapy. Toronto, Canada: Talus Incorporated.

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