Shin splints is one of the most common complaints in runners, military recruits and anyone who suddenly increases impact activity. It’s the dull, aching pain along the inner edge of the shin that builds as you run, may ease as you warm up, and returns afterwards. It’s frustrating, but it’s very treatable when the load is managed properly.
Understanding shin splints
Medial tibial stress syndrome is thought to be a response of the bone and the surrounding tissue to repetitive loading that has outpaced their ability to adapt. It sits on a spectrum of load-related shin problems, with bone stress injuries or stress fractures at the more severe end, which is why distinguishing it from a stress fracture matters. Diagnosis can be made reliably from your history and a careful physical examination.
Risk factors reported in research include a previous history of shin pain, higher body weight, and certain foot and hip characteristics, alongside rapid increases in training load, hard surfaces and worn or unsuitable footwear. Running-related injuries are common overall, and the shin is one of the more frequently affected areas.
Symptoms we commonly see
- A dull ache or soreness along the inner border of the lower shin
- Pain that comes on during running or jumping, may ease as you warm up and returns afterwards
- Tenderness when pressing along the inner edge of the shin
- Pain with impact activities such as running, jumping and court sports
- In more severe cases, pain with walking or at rest
Our evidence-based approach
Management centres on reducing the load that’s overloading the shin while building the capacity of the tissues around it. Our approach includes:
- Assessment of the shin, calf, ankle, foot and hip, your running history and training load, and screening for a possible stress fracture
- Load management, adjusting running volume and surface so pain settles without stopping all activity, with cross-training to maintain fitness
- Graded calf and lower-leg strengthening, building the tissues’ capacity to absorb impact
- Hip and trunk strengthening, because the whole leg shares the load
- Running retraining where it helps, such as step rate and footwear advice
- A graded return to running, progressed in small, planned steps
- Referral for imaging if a stress fracture is suspected
What to expect: recovery timeline
- Mild cases: often improve over a few weeks once load is managed
- Established shin splints: typically take a few months to settle fully, with running returned gradually
- Recurrent cases: benefit from looking at the training pattern, footwear and strength that allowed it to build
When to seek help urgently
Get assessed promptly if you have a single, very tender spot on the shin bone, pain that’s worsening, pain at rest or at night, swelling over the shin, or pain after a fall or impact. These can indicate a stress fracture and need proper assessment before you keep running.
References
- Winters M, et al. Medial tibial stress syndrome can be diagnosed reliably using history and physical examination. Br J Sports Med. 2018;52(19):1267-1272.
- Reinking MF, et al. Medial tibial stress syndrome in active individuals: a systematic review and meta-analysis of risk factors. Sports Health. 2017;9(3):252-261.
- Videbaek S, et al. Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Med. 2015;45(7):1017-1026.