What are shin splints?
Shin splints, or medial tibial stress syndrome (MTSS), are pain along the inside edge of the tibia (shinbone) caused by repeated stress on the muscles, tendons and the lining of the bone. They are common in runners, dancers, military recruits and athletes in jumping sports, particularly at the start of a season or after training changes. See dolor tibial (Spanish) and calf strain.
Symptoms
- A dull, aching or sore pain along the inner (and sometimes front) edge of the lower shin.
- Pain at the start of exercise that may ease as you warm up and return afterwards or the next morning.
- Tenderness when you press along the shin over a wide area (usually 5 cm or more).
- Mild swelling in some people.
- Pain after running, walking on hard surfaces or climbing stairs.
- Both legs may be affected.
- Pain gradually increases if training continues.
Why it happens
- Training errors: too much, too soon, too fast; sudden mileage or hill increases; adding speed work.
- Hard or uneven surfaces, such as concrete or banked tracks.
- Footwear: worn-out shoes (after 500–800 km) or shoes that do not suit your foot type.
- Biomechanics: flat feet (overpronation), high arches, tight calves, weak hip and foot muscles.
- Running technique: overstriding and heavy heel strike.
- Body factors: higher body weight, previous shin splints, low bone density and nutritional deficits.
- Female athletes with low energy availability or menstrual disturbance are at higher risk of bone stress injuries.
Shin splints versus stress fracture versus compartment syndrome
- Shin splints: diffuse tenderness along the shin; pain often eases when warm; improves with relative rest in weeks.
- Stress fracture: sharp, localised pain on one spot of the bone (the “one-finger test”), pain with hopping or at rest or night, pain that worsens during activity; needs imaging (MRI or bone scan) and longer rest, sometimes a boot.
- Chronic exertional compartment syndrome: tightness, burning, numbness or foot weakness during running that settles within minutes of stopping.
- Tendon problems such as tibialis posterior tendinopathy, with pain behind the ankle or inner foot. See tendonitis.
- Vascular and nerve problems are less common.
- A clinician’s examination helps tell them apart.
First steps: relative rest and pain control
- Stop or reduce impact activity until walking is pain-free, usually 1–4 weeks.
- Keep fit with cross-training: cycling, swimming, deep-water running, elliptical or rowing.
- Apply ice for 15–20 minutes after activity, several times a day, if it eases pain.
- Take paracetamol or short-term anti-inflammatories if suitable.
- Use compression sleeves or shin sleeves if comfortable.
- Wear supportive, cushioned shoes; consider insoles for flat feet or high arches.
- Avoid running on hard or sloping surfaces during recovery.
Strengthening and mobility
- Calf raises (straight knee and bent knee), 3 sets of 15, progressing to single-leg and loaded.
- Toe raises and heel walks to strengthen the front of the shin.
- Short-foot exercise and towel scrunches for the foot arch.
- Hip strengthening: bridges, clamshells and side-lying leg raises. See hip bursitis.
- Calf and soleus stretches, 30 seconds, 2–3 times.
- Foam rolling of the calves (not directly on the sore shin bone).
- Balance and single-leg stability work.
- Do these 3–4 times a week during recovery and keep doing them after you return to running.
Returning to running
- Resume when you can walk, hop and perform a single-leg squat without pain.
- Start with a run–walk programme on soft, flat surfaces (for example 1 minute run, 2 minutes walk, repeated for 20 minutes).
- Increase total weekly volume by no more than about 10%.
- Run every other day at first, and avoid speed and hills initially.
- Check cadence: a slightly higher step rate (about 5–10% more) reduces impact.
- Replace worn shoes and vary surfaces.
- Stop and rest if pain returns beyond a mild twinge that settles within 24 hours.
Preventing shin pain
- Increase mileage and intensity gradually.
- Mix in rest days and cross-training.
- Include strength training twice a week for legs, hips and core.
- Choose shoes that suit your foot and replace them regularly.
- Warm up and cool down; stretch calves.
- Eat enough, with adequate calcium, vitamin D and protein; seek advice if you have missed periods or recurrent injuries.
- Seek a gait analysis if problems recur.
When to see a clinician
- Pain lasting more than 2–3 weeks despite rest.
- Sharp pinpoint pain on the bone, pain at rest or at night.
- Swelling, redness, warmth or a lump.
- Numbness, tingling, weakness or a cold, pale foot: urgent.
- Pain after a fall or direct impact.
- Recurrent shin problems.
- Pain with fever or in a child or teenager that is unexplained.
Three common situations
A beginner runner who doubled mileage and now has aching inner shins: shin splints; cut back, cross-train and build gradually.
A runner with a sharp, one-spot pain that hurts when hopping: possible stress fracture; stop running and see a clinician.
A person with tight, burning calves that settle shortly after stopping: consider compartment syndrome.
Key points to remember
Shin pain after running is usually shin splints from overload; relative rest, strengthening, better shoes and a gradual return solve most cases. Pinpoint bone pain, night pain or swelling need assessment for a stress fracture. Our physiotherapy team can analyse your running and design a recovery plan.
This guide is for general information and does not replace an assessment by your own doctor or physiotherapist.
Questions about shin pain after running
These answers are general information and do not replace an examination or individual medical advice.
What causes shin pain after running?
Usually shin splints from overload; also stress fractures, tendon problems and compartment syndrome.
How long do shin splints take to heal?
Often 2–6 weeks with relative rest and a gradual return.
Should I keep running with shin splints?
Reduce or stop impact activity until walking is pain-free; cross-train.
How do I know it is a stress fracture?
Sharp, localised bone pain, pain at rest or night and pain with hopping.
Do new shoes help?
Worn or unsuitable shoes contribute; supportive, appropriate footwear helps.
Can I prevent shin splints?
Yes, with gradual training progression, strength work, good shoes and variety in surfaces.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.