Shin splints, or medial tibial stress syndrome (MTSS), is one of the most common overuse injuries in people who take part in high-impact activities, especially runners. It usually shows up as pain along the inner border of the shinbone (tibia), during or after exercise.
Written by Maeve McCormack, Podiatrist at Waldron Podiatry, Ballsbridge, Dublin 4
Shin splints are common, but persistent shin pain shouldn’t be ignored. Without the right load management and rehabilitation, it can disrupt your training, and in some cases it may point to a more significant bone stress injury.
What are the symptoms of shin splints?
- Pain or tenderness along the inner edge of the shinbone
- Pain that comes on during or after running or jumping
- Pain that may ease as you warm up, then return after exercise or the next morning
- Pain that gradually worsens if training carries on unchanged
What causes shin splints?
Shin splints are an overuse injury: the lower leg is asked to cope with more load than it’s ready for. Common contributing factors include:
- A sudden increase in training load, such as more distance, more sessions, faster running or a change in terrain
- Not enough recovery between sessions
- Poor or worn-out footwear
- Biomechanical and strength-related factors, such as how your foot and leg move and how strong your calves and hips are
- Low calcium or vitamin D levels, which can affect bone health
How are shin splints treated?
The main goals of treatment are to reduce excessive loading on the shin and restore the lower leg’s capacity to tolerate exercise.
1. Modify the activities that aggravate it
Temporarily reduce or stop the activities that bring on your shin pain, particularly running and jumping. Low-impact alternatives such as swimming or cycling can help you keep your fitness, as long as they don’t provoke symptoms. During recovery you may also need to cut your running distance or intensity whenever symptoms flare.
2. Gradually rebuild strength
Progressive strengthening is a key part of rehabilitation. Exercises may include:
- Calf raises
- Soleus strengthening (bent-knee calf raises)
- Tibialis anterior strengthening (the muscle at the front of the shin)
- Hip and single-leg strengthening
Exercises should be progressed gradually. Sharp, increasing or persistent pain is a reason to stop and have the programme reassessed.
3. Address mobility and movement limitations
Stretching or manual therapy may help when specific limitations are found. These should support load management and progressive strengthening, not replace them.
4. Consider foot orthotics
If the pain is persistent and there’s a biomechanical cause, custom foot orthotics may be considered as part of your treatment plan, following a full biomechanical assessment.
How to prevent shin splints
- Increase training gradually. Avoid sudden changes in distance, frequency, intensity or terrain.
- Build lower-limb strength. Keep up a consistent programme that develops calf strength, lower-limb strength and functional capacity suited to your sport.
- Prioritise recovery. Include rest or lighter training days, especially when you add new or demanding sessions.
- Wear appropriate footwear. Choose comfortable shoes suited to your activity and your feet, and replace them when they’re worn or no longer comfortable.
- Fuel properly. Keep up an adequate energy intake and a balanced diet.
- Respond to symptoms early. Persistent or worsening shin pain is a reason to adjust your training and get assessed, not to push through it.
When should you see a podiatrist about shin pain?
Book an assessment if your shin pain:
- Hasn’t improved after 2 to 3 weeks of reduced training
- Is getting worse, or is now there when you walk or rest
- Is sharp and focused on one specific spot on the bone
- Keeps coming back each time you return to running
At our Running Injury Clinic in Ballsbridge, we assess how you run, load and recover, using video gait analysis, FootScan pressure mapping and ForceDecks strength testing, and build a plan to get you back to running.
Frequently asked questions
Can I keep running with shin splints?
It depends on how severe your symptoms are. Many runners need to cut back or pause running for a while and cross-train with low-impact exercise. Running through pain that is sharp, worsening or persistent isn’t recommended.
How long do shin splints take to heal?
Recovery time varies from person to person and depends on how long you’ve had symptoms and how well training load is managed. Getting it assessed early usually means a quicker, smoother return to running.
Are shin splints the same as a stress fracture?
No. MTSS affects a longer stretch of the inner shin, while a bone stress injury tends to cause sharp pain at one specific spot on the bone. Untreated shin splints can progress, which is why persistent pain should be assessed.
Book a running assessment
If shin pain is affecting your running, our podiatrists can help. Podiatry assessments & treatment are €100 at Waldron Podiatry, 56 Lansdowne Road, Ballsbridge, Dublin 4. Call us on 087 408 2002 or book online.