Shin pain is a common problem for runners, walkers and people returning to sport or increasing their exercise. Often referred to as shin splints, the condition can make even simple activities uncomfortable and, if ignored, may become harder to settle.
The good news is that most cases can be managed successfully with the right combination of activity modification, strengthening and a gradual return to exercise.
Shin splints (medial tibial stress syndrome) is pain along the inner shin bone caused by loading the muscles, tendons and bone faster than they can adapt. Most cases settle without complete rest by temporarily reducing aggravating activity, progressively strengthening the calves and lower limb, and rebuilding training load gradually. Seek a physiotherapy assessment if the pain is very localised, present at rest or worsening.
What are shin splints?
“Shin splints” is a general term commonly used to describe pain along the inside of the shin bone. The medical term often used is medial tibial stress syndrome (MTSS).
It commonly develops when the muscles, tendons and bone around the shin are exposed to more load than they are currently able to tolerate.
You may notice:
- Aching or tenderness along the inner border of the shin
- Pain during or after running, jumping or brisk walking
- Tenderness when pressing along the shin
- Pain that improves with rest but returns when activity increases
Why do shin splints occur?
Shin splints often appear after a sudden change in training load. This might include starting a new running program, increasing your distance or speed, adding hills, returning to sport after a break or suddenly increasing the number of training sessions each week.
Other factors may also contribute, including reduced calf strength, limited ankle mobility, changes in footwear, running technique and insufficient recovery between training sessions.
Importantly, shin splints are not always caused by one single problem. For many people, it is a combination of training load and how well the body is prepared to tolerate that load.
Should you stop exercising?
Complete rest is not always necessary.
Instead, it is often more useful to temporarily reduce the activities that aggravate your symptoms while keeping active in other ways.
Depending on your pain, you may be able to substitute running or jumping with lower-impact exercise such as:
- Cycling
- Swimming
- Strength training
- Clinical Pilates
- Walking, if comfortable
A physiotherapist can help determine how much activity is appropriate and when it is safe to gradually increase your training again.
Strength is an important part of recovery
Improving the strength and capacity of the lower leg can help your body better tolerate running, jumping and sport.
Your program may include exercises targeting the:
Calf muscles: Calf raises and other progressive strengthening exercises can improve the ability of the lower leg to absorb and produce force.
Soleus: The deeper calf muscle plays an important role during running and can be strengthened with bent-knee calf exercises.
Foot and ankle: Strength and control through the foot and ankle may help improve how forces are managed during exercise.
Hips and legs: Strengthening the hips, glutes and larger muscles of the legs can also form part of a comprehensive rehabilitation program.
The important word is progressive. Exercises need to gradually become more challenging as your capacity improves.
Check your training load
One of the biggest mistakes people make is feeling slightly better and immediately returning to their previous training volume.
For example, if your shin pain started after suddenly moving from two runs per week to five, returning straight back to five runs once the pain settles may simply restart the problem.
A better approach is to gradually rebuild your:
- Running frequency
- Distance
- Speed
- Hills
- Jumping
- Sport-specific training
Changing one variable at a time can also make it easier to identify what your body is tolerating.
What about footwear?
There is no single “best shoe” for preventing shin splints.
However, shoes that are excessively worn, uncomfortable or unsuitable for your activity may contribute to symptoms.
If you have recently changed your footwear and your shin pain started soon afterwards, it may be worth discussing this with your physiotherapist.
When should you have shin pain assessed?
Not every pain in the shin is a simple case of shin splints.
Stress reactions and stress fractures can also cause lower-leg pain and may require different management.
We recommend having your symptoms assessed if:
- The pain is very localised to one small area
- You have pain at rest or at night
- The pain is becoming progressively worse
- You are limping
- You cannot comfortably hop on the affected leg
- Your symptoms are not improving despite reducing your training
Early assessment can help establish what is causing the pain and prevent a minor problem from becoming a longer-term injury.
How can physiotherapy help?
At PhysioXtra, our Adelaide physiotherapists can assess the factors contributing to your shin pain rather than simply treating the painful area.
Your assessment may include your ankle mobility, calf strength, lower-limb strength, balance, running or movement patterns and recent changes in training.
From there, we can develop an individual program designed to settle your symptoms, build strength and gradually return you to the activities you enjoy.
Don’t let shin pain stop you moving
If shin splints are interfering with your running, sport or exercise, getting the right advice early can make a significant difference.
Book an appointment at your nearest PhysioXtra clinic for an assessment and personalised return-to-exercise plan. Book online or call us on (08) 8357 4988.
Frequently asked questions
Are shin splints and MTSS the same thing?
Yes. “Shin splints” is a general term for pain along the inner shin bone, and the medical term is medial tibial stress syndrome (MTSS). It develops when the muscles, tendons and bone around the shin are exposed to more load than they can currently tolerate, often after a sudden change in training.
Should I stop running if I have shin splints?
Complete rest is not always necessary. It is often more useful to temporarily reduce the activities that aggravate your symptoms while staying active with lower-impact options such as cycling, swimming or Clinical Pilates. A physiotherapist can help determine how much activity is safe.
How long do shin splints take to heal?
Recovery time varies from person to person and depends on how long symptoms have been present and how well training load is managed. Rather than a fixed timeframe, the priority is a progressive rebuild of lower-leg strength and training so the shin can tolerate running and sport again without the pain returning.
What exercises help shin splints?
Strengthening the calf muscles, soleus, foot and ankle, and the hips and legs helps the lower limb tolerate running and jumping. Exercises should be progressive, gradually becoming more challenging as your capacity improves. The same graded approach applies to managing tendon and muscle load generally.
When should I see a physio for shin pain?
Seek an assessment if the pain is very localised to one small area, present at rest or at night, progressively worsening, causing a limp, stopping you hopping on the affected leg, or not improving despite reduced training. Early assessment helps prevent a minor problem becoming a longer-term injury. You can book an appointment online.
Can my footwear cause shin splints?
There is no single best shoe for preventing shin splints, but shoes that are excessively worn, uncomfortable or unsuitable for your activity may contribute to symptoms. If your shin pain started soon after changing footwear, it is worth discussing this with your physiotherapist.
