Shin Splints
Shin splints are almost always a load-and-capacity problem. Treat the cause and they settle — ignore it and they return with the next training block.
What is shin splints?
Shin splints, or medial tibial stress syndrome, describes pain along the inner edge of the shin bone where the deep calf muscles attach. It is one of the most common complaints in runners, especially early in a training programme.
The tissue is irritated by repeated impact that exceeds what the bone and muscle attachment are currently prepared for. It sits on a spectrum: managed early it settles quickly, but ignored it can progress towards a bone stress injury.
Because the pattern of pain matters clinically, assessment always screens for stress fracture and for compartment-related causes before rehabilitation begins.
Common symptoms
- Diffuse ache along the inner shin, usually 5–15cm above the ankle
- Pain that builds during a run and lingers afterwards
- Tenderness when pressing along the shin bone
- Pain on hopping or impact
- Symptoms worse on hard surfaces or in worn shoes
- Tightness through the calves and shins
- Pain that returns each time mileage increases
What causes it
- Too much running volume added too quickly
- A high proportion of hard-surface or downhill running
- Reduced calf, foot and hip strength
- Worn-out or unsuitable footwear
- Overstriding or low running cadence
- Reduced bone loading history — new or returning runners
- Low energy availability, poor sleep or inadequate nutrition
How physiotherapy helps
The first job is to rule out a bone stress injury and identify exactly which tissues are irritated. The second is to find out why the load exceeded your capacity in the first place — usually a combination of training history, strength and mechanics.
Treatment combines short-term load modification with progressive strengthening of the calf, foot and hip, plus practical running technique changes. Most runners are back to full training within four to eight weeks, and better prepared than before.
- Training load modification and cross-training options
- Progressive calf, foot and hip strengthening
- Impact-loading progression to build bone tolerance
- Soft tissue therapy and dry needling to the calf
- Running cadence and technique coaching
- Footwear and surface guidance
- Return-to-running plan with clear progression rules
When to seek treatment
- Shin pain that persists beyond a week of easier training
- Pain that narrows to one small, very tender spot
- Pain when walking or at night — this needs urgent review
- Shin pain that recurs with every training block
- Numbness, pins and needles or a swollen, tight shin
Frequently asked questions
Let's get you moving again
If this sounds like what you're dealing with, an assessment is the quickest way to understand it properly. Shin Splints responds well to the right plan.