How Do I Fix Shin Splints?

Foot/Ankle Injuries, Running and Sports Performance

How Do I Fix Shin Splints?

Shin splints are one of the most common injuries among runners, athletes, and anyone who suddenly increases their activity level. The pain can range from a mild annoyance to a debilitating problem that prevents you from exercising altogether. Fortunately, most cases of shin splints respond very well to the right treatment approach. The first step in fixing shin splints is understanding what they actually are.

What Are Shin Splints?

“Shin splints” is a general term often used to describe pain along the the shin bone (tibia). The medical term is Medial Tibial Stress Syndrome (MTSS). The condition occurs when the muscles, tendons, and connective tissues that attach to the tibia become overloaded. Repetitive stress causes irritation of these tissues and can eventually lead to inflammation and pain. Pain is often felt along the lower two-thirds of the inside of the shin and may worsen during running, jumping, or prolonged walking. Shin splints are particularly common in:

  • Runners
  • Basketball players
  • Soccer players
  • Individuals starting a new exercise program

Why Do Shin Splints Occur?

One of the biggest misconceptions about shin splints is that they are simply a problem of the shin itself. In reality, shin splints are usually the result of excessive stress being placed on the lower leg due to factors elsewhere in the body. Common contributors include:

Training Errors

Perhaps the most common cause is doing too much, too soon. The body adapts to stress gradually. When training increases faster than tissues can adapt, pain often develops. Examples include:

  • Increasing mileage too quickly
  • Adding speed work abruptly
  • Running hills more frequently
  • Returning to exercise after a long break

Weakness

Many people with shin splints have weakness throughout the kinetic chain. If larger muscles are not doing their job effectively, the lower leg may be forced to absorb more stress than it was designed to handle. Common areas include:

  • Calf muscles
  • Foot muscles
  • Gluteal muscles
  • Hip stabilizers
  • Core musculature

Mobility Restrictions

Limited mobility can alter running and walking mechanics. Restricted motion can force compensations that increase loading through the shin. Areas commonly involved include:

  • Ankle mobility
  • Calf and Achilles tendon flexibility
  • Big toe mobility
  • Hip mobility

Poor Recovery

Recovery is where the body adapts to training and becomes stronger. While exercise provides the stimulus for improvement, it is during recovery that tissues repair, remodel, and build resilience. Factors such as poor sleep, inadequate nutrition, high stress levels, and insufficient recovery days can impair the body’s ability to recover and tolerate training loads effectively. When recovery is compromised, the risk of overuse injuries such as shin splints may increase, even if the training program itself is well designed. Ensuring adequate sleep, proper nutrition, stress management, and appropriate rest between training sessions is an essential part of both preventing and recovering from shin splints.

Should I Stop Running?

Not necessarily. Many runners believe they must completely stop all activity the moment shin pain develops. In reality, the answer depends on symptom severity. If pain is mild and does not worsen during or after activity, training modifications may be sufficient. However, if pain continues to worsen despite modifications, a temporary reduction in impact activities may be necessary. The goal is to reduce symptoms enough to allow healing while maintaining as much fitness as possible.

Examples of ways to modify include:

  • Reducing mileage temporarily
  • Eliminating speed work
  • Avoiding hills
  • Adding recovery days

Strengthening Is Often the Missing Piece

Many people focus exclusively on stretching when they develop shin splints. While mobility can be helpful, strength training is often the more important intervention. Research consistently demonstrates that stronger tissues are more resilient tissues. Important areas to strengthen include:

  • Calves
  • Feet
  • Hips
  • Core
  • Thigh Muscles

Improve Running Mechanics

Running form can influence how forces are distributed throughout the body. A running assessment may help identify mechanical factors contributing to symptoms. This does not mean there is one perfect running style. Small adjustments can sometimes significantly reduce stress on the shin. Factors that may contribute to excessive stress include:

  • Overstriding
  • Excessive stomping when running
  • Poor trunk control

Footwear is Very Important

Shoes usually do not cause shin splints by themselves, but they can definitely play a role. The most important factor is often finding a shoe that feels comfortable and allows you to run naturally. There is no universally best shoe for preventing shin splints. When evaluating shoes, important considerations include:

  • Age of the shoe
  • Running volume
  • Comfort
  • Individual biomechanics and foot size

Gradual Return to Running

As symptoms improve, it is important to return to activity gradually. Many runners make the mistake of feeling better and immediately resuming their previous mileage. Unfortunately, symptoms often return. A structured progression allows tissues to adapt safely. Patience during this phase often prevents setbacks. Common strategies include:

  • Walk-run intervals
  • Gradual mileage progression
  • Alternating hard and easy days
  • Monitoring symptoms closely

When Should You Seek Physical Therapy?

If shin pain persists for more than a few weeks, repeatedly returns, or limits your ability to train, physical therapy may be beneficial. A comprehensive evaluation should assess more than just the shin itself. At Schafer Physical Therapy, we evaluate the entire kinetic chain, including the feet, ankles, knees, hips, pelvis, trunk, and running mechanics. The goal is not only to reduce pain but also to identify and address the underlying factors that caused the problem in the first place. Treatment may include:

  • Manual/Hands-on therapy
  • Mobility exercises
  • Strength training
  • Running analysis
  • Return to running progressions

In Conclusion

Most shin splints are highly treatable. The key is understanding that the pain is often a symptom of a larger issue involving training load, strength, mobility, recovery, or running mechanics. Rather than simply resting and hoping the pain disappears, a comprehensive approach that addresses the entire body typically produces the best long term results. With the right treatment plan, most people can return to running stronger, more resilient, and less likely to experience recurrent shin pain in the future.

Thanks for reading! Are you ready to fix your shin splint pain? Please call 240-626-6454 or email philippe@philippeschafer.com to schedule a free 15 minute consultation or full 60 minute evaluation in the office.