Ankle & foot
Shin Splints (Medial Tibial Stress Syndrome)
Aching pain along the inner shin bone brought on by running or marching, usually after a jump in training. Managed with load changes, strengthening and orthotics.
Common symptoms
- Dull ache along the inner edge of the shin, usually the lower half
- Tenderness over a stretch of several centimetres when pressed
- Pain during or after running, marching or jumping
- Pain that starts earlier in each session if training continues
- Mild swelling or puffiness along the shin
- Often both legs, though one may be worse
- Pain eases with rest in the early stages
Overview
"Shin splints" is the everyday name for medial tibial stress syndrome — pain along the inner edge of the shin bone (tibia), usually over the lower half. It happens when the bone and the tissues attached to it are loaded faster than they can adapt, most often in the first weeks of a new running programme, a return to sport after a break, or a switch to harder surfaces.
The pain is typically a diffuse ache over a stretch of several centimetres along the inner shin, tender to press. Early on it appears during or after running and settles with rest; if training continues unchanged, it can start earlier in each session and linger for hours afterwards. It is very common in new runners, military recruits, dancers and people in jumping sports.
The important distinction is between shin splints and a tibial stress fracture. A stress fracture produces a more focused, pinpoint tenderness and pain that persists with walking or even at rest. Because the treatment and timescale differ, this is one of the main things we check.
Causes and risk factors
- Increasing running distance, speed or frequency too quickly
- Running on hard or cambered surfaces
- Flat feet or excessive pronation, which increase the twisting load on the shin
- Weak calf and hip muscles
- Worn-out or unsupportive trainers
- Being new to running or returning after a long break
- Low energy availability or poor bone health (relevant for stress fractures) — your GP can advise
How we may be able to help
Assessment first. We examine the shin to distinguish diffuse shin splints from a focal stress reaction, check calf strength and endurance, assess ankle and foot mechanics, and go through your training history in detail. If a stress fracture is suspected, we can arrange an online private GP consultation for imaging and will adjust the plan accordingly.
Physiotherapy centres on managing load so the bone and tissues can recover without you losing all your fitness — usually by replacing some running with cycling, swimming or pool running for a period, then building back on a structured schedule. Alongside this, rehabilitation exercise strengthens the calves, feet and hips, which share the load more evenly, and we may suggest small adjustments to running technique. Manual therapy or soft-tissue work on tight calf muscles may help with comfort.
Foot posture is a frequent contributor. A 3D foot scan assesses how your arches load, and custom orthotics may be recommended to reduce the pronation-related strain on the inner shin. Kinesiology taping along the shin can provide short-term relief during the return to running. Interferential therapy may be used as an adjunct for pain in the early phase.
What you can do at home
- Reduce running volume now — usually by half or more — rather than pushing through it
- Keep fitness up with low-impact alternatives: cycling, swimming, elliptical
- Stretch and strengthen the calves daily (calf raises, both straight and bent knee)
- Replace trainers that have done more than 500–800 km, and avoid very flat shoes
- Run on softer, flat surfaces when you do run
- Follow the "10% rule": increase weekly running distance by no more than about 10%
When to seek urgent help
If you have any of the following, call us straight away for an urgent same-day appointment — we can examine you and arrange fast-track X-ray or MRI through our imaging partner. If you cannot reach us, go to A&E. For loss of bladder or bowel control, numbness around the groin, chest pain, a sudden severe headache or rapidly worsening weakness, call 999 or go to A&E immediately:
- Pinpoint tenderness on one spot of the shin bone, or pain that persists at rest or at night — possible stress fracture, needs assessment and imaging
- Severe, tight, cramping calf or shin pain during exercise with numbness or weakness in the foot — possible compartment syndrome, seek urgent care
- Hot, red, swollen shin with fever
- Shin pain after a direct impact with inability to bear weight
Frequently asked questions
How do I know if it's shin splints or a stress fracture?
Shin splints cause diffuse tenderness over several centimetres and settle with rest. A stress fracture is tender at one precise spot, hurts with walking and may ache at night. We examine for this at your first visit and arrange imaging if needed.
Do I have to stop running completely?
Usually not completely, but a significant reduction is needed early on. We help you keep fitness with low-impact training and then return to running on a planned schedule.
Will orthotics help?
If your foot scan shows excessive pronation, custom orthotics may reduce the twisting strain on the shin and are often part of the plan. They work most effectively alongside strengthening and sensible load progression.
How long does it take to recover?
Mild cases often improve within a few weeks of reducing load; longer-standing cases take longer. Returning too quickly is the most common reason for a relapse, so we pace the return carefully.
This page is general information, not a diagnosis. A clinician will assess you before recommending any treatment. Outcomes vary from person to person. Written with reference to NHS and other peer-reviewed guidance.
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