pain returns. Individuals should consider running on other surfaces besides asphalt, such as grass, to decrease the amount of force the lower leg must absorb. Orthoses and insoles help to offset biomechanical irregularities, like pronation, and help to support the arch of the foot. Other conservative interventions include improving form during exercise, footwear refitting, orthotics, manual therapy, balance training (e.g., using a balance board), cortisone injections, and calcium and vitamin D supplementation. Deep tissue massage is one of the massage techniques that may be useful. A technique such as deep transverse friction to relieve muscle tightness will help stop the build-up of scar tissue. This can overall release tension in the calf muscle area, relieving pressure that is causing pain. Less-common forms of treatment for more-severe cases of shin splints include extracorporeal shockwave therapy (ESWT) and surgery. Surgery does not guarantee 100% recovery, and is only performed in extreme cases where non-surgical options have been tried for at least a year. Epidemiology Rates of shin splints in at-risk groups are 4% to 35%. Women are affected more often than men. References External links Overuse injuries Dislocations, sprains and strains