Shin splints
Your health expert John Fairhurst, Senior Musculoskeletal Physiotherapist, Bupa
Content editor review by Dr Kristina Routh, July 2021
Next review due July 2024
Shin splints is a type of pain in your lower leg around your shin bone, which usually comes on when you’re exercising. Shin splints isn’t usually serious and there’s a lot you can do yourself to improve your symptoms.
About shin splints
The medical name for shin splints is ‘medial tibial stress syndrome’ (MTSS). Your tibia is your shin bone, the main bone of your lower leg.
Shin splints is one of the most common injuries to the lower leg. It can happen when you do a lot of running or other vigorous activity. Up to one in five runners get shin splints. It’s common in athletes, dancers and people in the military. You’re more likely to get shin splints if you’re a woman, or if you’re overweight.
Doctors aren’t sure yet exactly what causes shin splints. But it’s linked to repeated stress on your bone and the tough membrane covering it (the periosteum). This leads to inflammation which causes pain and tenderness along the inside edge of your tibia.
Other causes of shin pain
Sometimes shin pain can have other causes.
- Stress fractures. These are small breaks in your tibia, caused by repeated stress on the bone.
- Muscle strain. This is where you’ve overstretched certain muscles in the front of your leg. This damages some of the muscle fibres.
- Chronic exertional compartment syndrome (CECS). The muscles in your lower leg lie within an enclosed compartment of tissue. In CECS, pressure builds up within that compartment, making it harder for blood to flow into the muscle. This reduces the amount of oxygen reaching your muscle, leading to pain.
- Tendon problems (tendinopathy). Overloading or overusing a tendon can cause pain and swelling.
Symptoms of shin splints
Shin splints gives you pain and tenderness along the inner side of your lower leg. The pain may be sharp, or dull and throbbing. It can be very severe.
You may notice:
- the pain begins when you start exercising
- the pain seems to get better as you continue to exercise
- the pain goes away when you rest
- the painful area of your leg feels tender if you touch it
If your pain is very bad or getting worse, you should speak to your physiotherapist or GP. They can then check you for other things that might be causing your shin pain. For more information about these, see our section ‘other causes of shin pain’.
The pain from a stress fracture tends to get worse from one workout to the next. And the pain and tenderness are usually only in a small area, over the fracture. If the muscle in your leg is swollen and feels tight as well as being painful, you may have compartment syndrome.
Diagnosis of shin splints
If you have shin pain, you can try to manage it yourself with rest and painkillers before seeing a physiotherapist or GP. For more information, see Self-help for shin splints.
But you should see a physiotherapist or your GP if:
- the pain is so severe you have to stop exercising straightaway
- the pain isn’t getting better or is getting worse
- the pain continues even though you’ve stopped exercising and you’re resting your leg
- you have pain when you’re resting without an obvious cause, such as doing a new activity or exercise regime
- your muscle feels very tight and hard, which could be a sign of compartment syndrome
- you have swelling over your shin bone
If your GP thinks you have shin splints, they may suggest you see a physiotherapist. In some cases, they may refer you to a specialist in sport and exercise medicine. This is usually only available privately.
Your physiotherapist or GP will ask about your symptoms and examine you. They may also ask about your medical history and how often you exercise. Shin splints can usually be diagnosed without doing further tests.
Your GP may arrange an X-ray to rule out other causes of shin pain, such as a stress fracture.
Self-help for shin splints
Here are some things you can do yourself to treat shin splints.
- Stop doing the activity that caused your shin splints and rest for at least two to six weeks. Instead, do other activities that don’t put strain on your legs. This may include swimming or cycling.
- If you need pain relief, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine.
- Try ice packs to help relieve any pain. Wrap your ice pack in a towel – don’t put it straight onto your skin. Hold it in place for 15 to 20 minutes after exercise.
- Gently stretch your calf muscles. Stand with both feet on a step, with your heels off the edge. Raise yourself up on the balls of your feet. Then slowly lower your heels to below the level of the step. Return to your starting position. Do this in three sets of 25 repeats, every other day. If you do this with straight knees then bent knees, this will target the main calf muscles.
- Shock-absorbing insoles for your shoes may help to cushion your feet when you run. Specialist running shops can give you advice and information about your sports shoes.
- You can start exercising again when you have been pain free for at least two weeks. Start slowly and build up gradually. If you get shin splints again, stop the activity. Rest for a few days before starting the exercise at a lower level of intensity.
- Run on a soft surface such as grass or a treadmill, rather than on hard roads.
It’s important to pay attention to your body. So find a level of exercise that it can tolerate. Slowly build on that, while allowing your shin enough time to heal.
Treatment of shin splints
Shin splints can usually be treated at home. But see your physiotherapist or GP if the pain is very bad or isn’t getting better.
Physiotherapy
If you see a physiotherapist, they’ll agree with you a plan for treating your shin splints. This will include exercises to stretch and strengthen the muscles of your lower leg and reduce the stress on the bones. They may also encourage you to eat a healthy diet and get enough sleep to help your bones recover.
A physiotherapist can show you the best way to increase your level of activity once the pain has gone. They may also help you improve the way you walk or run. This can help you to avoid shin splints coming back.
Shoe inserts (orthotics)
Specially made orthotic insoles for your shoes may help to treat and prevent shin splints. Your GP may refer you to a podiatrist who can fit these. These insoles might work by changing the way you walk or run, if this could be causing your shin splints. Or they may work by reducing the stress on your tibia.
Causes of shin splints
You may get shin splints if you’re putting too much stress and strain on your shin bone (tibia) and the tissues around it. Your bone and tissue can cope with a certain amount of impact. But if you keep putting too much stress on your bone, it may become inflamed.
You're more likely to get shin splints if:
- you’re a woman (although we don’t know for sure why this is)
- you’re overweight
- you’ve just started doing a new vigorous activity
- your sport or activity involves running or jumping on a hard or slightly curved surface, such as a road
- you have a poor running technique
- your shoes don't fit well, are worn out or don't have enough cushioning and support
- you have flat feet
- you’ve changed your running pattern or the surface that you run on – such as from a treadmill to the road
Prevention of shin splints
There are lots of things you can do to help prevent shin splints.
- Wear sports shoes or trainers that cushion and support your feet properly. Consider getting your running shoes fitted at a specialist running shop.
- Choose shoes that are designed for your type of activity.
- Trainers lose their ability to absorb shock after a while, so replace them after 250-500 miles.
- When you start or restart an activity, build up the intensity gradually.
- Wear orthotic shoe inserts if your doctor or physiotherapist recommends them. Cushioned insoles may help too.
- Avoid training just on hard surfaces, such as roads.
- Do some stretching exercises for the front of your calves before you do any physical activities or sports. Use warm-up exercises that are like the kind of exercise you’ll be doing, such as lunges or squats.
- Alternate low impact exercise, like swimming, cycling or using a cross trainer with your higher impact activity.
It can be frustrating if you have to stop an activity that you enjoy. But you really do need to stop doing what caused the shin splints until the pain no longer returns. If you don’t rest enough, it may take longer to recover fully. But this doesn't mean you have to give up exercise completely. You can keep active by doing sports that don't put any strain on your shins, such as swimming or cycling.
If you have shin splints, you’ll get pain in your lower leg when exercising. The pain is usually along the inner edge of the lower two thirds of your tibia (shin bone). It can be quite severe. This area may also feel tender to the touch. The pain goes away when you rest. For more information, see our section on symptoms of shin splints.
The pain of shin splints comes on when you exercise and goes away when you rest. This will keep happening until you take a long period of rest from the activity which caused them. This may be from two to six weeks, but may be longer.
To heal shin splints, you need to stop doing the activity which caused the pain for a period of at least two to six weeks. Then very gradually build up your activity again. A physiotherapist can help you recover from shin splints and advise you how to prevent them in future. For more information, see our section on treatment of shin splints.
You may have come across the use of compression stockings or taping for treating or preventing shin splints. At the moment, there is no strong evidence that either of these treatments work. If you are considering using them, talk to your physiotherapist about how they may help in your particular circumstances.
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- Shin splints. Patient. patient.info/doctor, last edited January 2015
- Shin splints. The MSD Manuals. www.msdmanuals.com, last full review/revision January 2020
- McClure CJ, Oh R. Medial tibial stress syndrome. [Updated 2021 May 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. ncbi.nlm.nih.gov
- Musculoskeletal problems. Oxford Handbook of General Practice (online). Oxford Medicine Online. www.oxfordmedicine.com, published June 2020
- Shin splints. OrthoInfo. American Academy of Orthopaedic Surgeons. orthoinfo.aaos.org, last reviewed August 2019
- Chronic exertional compartment syndrome. Medscape. www.emedicine.medscape.com, updated January 2021
- Stress fractures. Medscape. www.emedicine.medscape.com, updated March 2020
- First aid in general practice. Patient. patient.info/doctor, last edited February 2017
- Bone tumours. Patient. patient.info/doctor, last edited June 2015
- Compartment syndrome. Patient. patient.info/doctor, last edited January 2015
- Bliekendaal S, Moen M, Fokker Y, et al. Incidence and risk factors of medial tibial stress syndrome: a prospective study in physical education teacher education students. BMJ Open Sport Exerc Med 2018; 4(1):e000421, published October 2018
- Sprains and strains. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2020
- Galbraith RM, Lavallee ME. Medial tibial stress syndrome: conservative treatment options. Curr Rev Musculoskelet Med 2009; 2(3):127–33. doi: 10.1007/s12178-009-9055-6
- Hamstra-Wright KL, Huxel Bliven KC, Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. Br J Sports Med 2015; 49:362–69
- Reinking MF, Austin TM, Richter RR, et al. Medial tibial stress syndrome in active individuals: a systematic review and meta-analysis of risk factors. Sports Health 2017; 9(3):252–61. doi: 10.1177/1941738116673299
- Winters M, Eskes M, Weir A, et al. Treatment of medial tibial stress syndrome: a systematic review. Sports Med 2013; 43(12):1315–33. doi: 10.1007/s40279-013-0087-0
- Personal communication, John Fairhurst, Senior Musculoskeletal Physiotherapist, July 2021
