Shin splints are a familiar frustration for many runners, especially those who are new to running or building up for an event. The pain usually sits along the inner edge of the shin bone and can make every run feel harder than it should.
While shin splints are common, they are also a sign that your legs are not yet coping with the load you are asking of them. With the right adjustments, most people can settle their symptoms and build back up to running.
What are shin splints?
"Shin splints" is a general term for pain along the shin. The most common cause is medial tibial stress syndrome (MTSS), which is pain along the inner border of the tibia, usually in the lower third of the leg.
MTSS is thought to be a bone stress reaction, where the bone and its surrounding tissues are under more load than they can currently adapt to. It sits on a spectrum with stress fractures, which is why it is important not to ignore persistent shin pain. Our page on shin splints treatment explains more about assessment and care.
What causes shin splints?
The main driver is usually too much load, too soon. Bone adapts to running over weeks and months, and if training increases faster than that adaptation, symptoms can appear. Common contributing factors include:
A rapid increase in running distance, frequency or speed
Starting a new program, such as a couch to 5k or preseason training
Changing to harder surfaces, or a lot of running on concrete
Reduced calf and foot strength, which affects shock absorption
Previous shin splints or a stress fracture
Worn out or very different footwear
Not eating enough to fuel training, which may affect bone health
Research suggests shin splints are more common in women and in people with less running experience. Low energy availability, where you are not eating enough for the amount you train, can affect hormones and bone health, so it is worth discussing with your GP if this sounds familiar.
How do you know if it is shin splints or a stress fracture?
Shin splints tend to cause a diffuse ache along a longer section of the shin, often at least five centimetres. The pain may be worse at the start of a run, ease as you warm up, then return afterwards.
A stress fracture is more likely if the pain is in one small, very tender spot, gets worse as you keep running, is present at rest or at night, or makes it painful to hop on that leg. If any of these sound familiar, stop running and get assessed. You can read more on our stress fracture rehabilitation page.
How are shin splints treated?
Treatment focuses on reducing load to a level the bone can tolerate, then gradually building capacity. Approaches that may help include:
Relative rest: reducing or pausing running while keeping fitness up with cycling, swimming or deep water running
Calf and foot strengthening: heel raises, single leg balance and foot exercises to improve shock absorption
Hip and trunk strength: to help control how load travels through the leg
Footwear review: checking that your shoes suit your feet and training
Soft tissue care: massage or other hands-on treatment may help with tight or sore calf muscles
Running technique: small changes, such as a slightly higher step rate, may reduce load on the shin for some runners
A running assessment can look at your technique, training and footwear to identify factors that may be contributing.
How do you get back to running after shin splints?
Returning gradually is the key to avoiding a cycle of flare-ups. Before you start, you should be able to walk briskly and hop on the affected leg without pain. From there, a structured return might look like this:
Begin with a walk to run program, such as alternating one minute of running with one to two minutes of walking
Run on alternate days at first to allow recovery between sessions
Increase total time before adding speed, hills or longer runs
Choose softer, even surfaces such as grass or trails where possible
Continue your strength exercises two to three times a week
Monitor pain: mild discomfort that settles by the next day is usually acceptable, but sharp or increasing pain is a sign to ease off
Most people can return to running within a few weeks to a few months, depending on how long symptoms have been present. Our blog on why runners get injured explains how to balance training load and recovery.
Which strength exercises are often included in shin splints rehab?
Strength work helps your lower legs tolerate the load of running again. Your physio will tailor a program to you, but it often includes exercises such as:
- Calf raises on both legs, progressing to single-leg raises, with the knee straight and then slightly bent
- Toe raises or tibialis raises, lifting the front of the foot while leaning back against a wall
- Single-leg balance, progressing to soft surfaces or eyes closed
- Hip and glute exercises such as side-lying leg lifts, bridges and step-ups
Exercises should feel challenging but not provoke sharp shin pain. If you are unsure how to progress, our sports injury treatment team can help.
When should you see a GP or seek urgent care?
See your GP or seek urgent care if you have:
Pain in one small spot on the bone that is very tender to touch
Pain at rest, at night, or when walking
Pain or difficulty hopping on the affected leg
Significant swelling, redness or warmth in the lower leg
Numbness, tingling, a cold foot or a feeling of tightness that does not ease after exercise
Calf swelling and pain that could suggest a blood clot
Frequently asked questions
Can I run through shin splints?
Running through worsening pain is not recommended, as it may increase the risk of a stress fracture. Some people can continue with reduced running if pain stays mild and settles quickly, but it is worth having your shins assessed first.
Will new shoes help shin splints?
Footwear can play a part, especially if your shoes are worn out or you have changed styles recently. However, shoes alone rarely solve shin splints. Managing training load and building strength are usually more important.
How can I prevent shin splints coming back?
Increase training gradually, include regular strength work for your calves, feet and hips, vary your running surfaces, and make sure you eat enough to support your training. Paying attention to early warning signs can help you adjust before pain builds.
Getting help on the Gold Coast
If shin pain is getting in the way of your running, our team at The Good Joint in Mermaid Beach can assess your legs, training and technique and help you plan a gradual return. See our physiotherapy services or book online.
Related reading: What is runner's knee and how do you treat it? and What helps Achilles tendinopathy, and what should you avoid?
