Shin Splints: How to Manage Pain and Get Back to Exercise
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.
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
- 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 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 with your PhysioXtra physiotherapist for an assessment and personalised return-to-exercise plan.
