Most people with shin splint pain never need to go to the doctor for a formal diagnosis. However, athletes may want to consult with their doctors if shin splint pain is not relieved after a couple of weeks of resting, icing, and taking over-the-counter NSAIDs, such as ibuprofen.

See The P.R.I.C.E. Protocol Principles for acute injury treatment information

To make a diagnosis, the doctor will conduct a patient interview and physical examination and possibly also medical imaging.

Patient interview
The doctor will ask the patient many questions, including questions about his or her training regime, what brings on pain and what relieves pain.

Physical examination
Pain along the medial tibia is most often present with running and sports, but may progress to be triggered by walking as well. Tenderness to palpation is present along the medial tibial border. Tight calf muscles and decreased ankle motion are common. Neurovascular exam is normal.

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Medical imaging
X-rays, bone scan, and MRI are often negative with shin splints, but they may help to differentiate shin splints from stress fractures. X-rays may demonstrate some generalized periosteal thickening. A bone scan may demonstrate some generalized uptake of the tracer substance used in these scans along a length of the medial tibia, which indicates locations where the bone's metabolism is increased. This differs from the intense uptake seen in a medial tibial stress fracture.

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After diagnosis, a doctor can recommend a course of treatment tailored to the patient and his or her training program.

Dr. Robert Wilder is a sports medicine physician serving as Chair of the Department of Physical Medicine and Rehabilitation at the University of Virginia School of Medicine and as Medical Director of The Runner’s Clinic and the UVA SPEED Clinic Motion Analysis Lab. He also directs the Primary Care Sports Medicine Fellowship Program.

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