Shin splints

Expert reviewer, Dr Adrian Raby, General Practitioner
Next review due March 2022

Shin splints is the name for pain in your shin bone (tibia), which is at the front of your leg, between your knee and your ankle. The pain usually starts or gets worse when you exercise, especially when you’re running, jogging or walking very fast. Shin splints isn’t usually serious but can stop you exercising.

A runner is taking breath

About shin splints

Shin splints is often used to describe any sort of shin pain. But it’s usually caused by repeatedly putting weight on your legs, such as when you do a lot of running. It’s especially common in athletes, dancers and people who work in the military.

Shin splints is sometimes used as another name for medial tibial stress syndrome (periostitis). Doctors don’t yet fully understand what causes it. But repeated stress on your bone may inflame the tissue around it, and the periosteum – the tough membrane covering it.

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’re prone to overstretching certain muscles in the front of your leg, damaging some of the muscle fibres.
  • Chronic exertional compartment syndrome. When you exercise, the extra blood flow to your muscles makes them swell up. Your muscles sit inside an enclosed compartment of stiff tissue, so they don’t have much room to expand. If this tissue can’t expand well enough, the pressure inside increases and blood can’t flow into your muscle. This reduces the amount of oxygen reaching your muscle, leading to pain. Chronic exertional compartment syndrome isn’t very common.
  • Tendon problems (tendinopathy). Overloading or overusing a tendon can cause pain and swelling.

Symptoms of shin splints

If you have shin splints, you’re likely to notice an aching pain and tenderness along the front or sides of your lower leg. The pain may be very bad, especially when you’re climbing stairs.

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, you should speak to your physiotherapist or GP. If you have a stress fracture, only a small area of your leg will usually feel tender. With a stress fracture, you may also find the pain keeps getting worse every time you exercise and from one workout to the next. If the muscle in your leg feels tight, 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 making an appointment with 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 isn’t getting better or is getting worse, 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
  • there’s any sign of a possible stress fracture, such as very bad pain that means you have to stop exercising straightaway
  • 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, but 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.

Your physiotherapist or GP will usually be able to diagnose shin splints without doing any further tests. But if they think you may have a stress fracture, your GP may arrange an X-ray to rule out other causes. An X-ray doesn’t always pick up fractures, so you may need a bone scan or an MRI scan instead.

Treatment of shin splints

Shin splints can usually be treated at home with plenty of rest, some simple self-help measures and painkillers to ease the pain. But see your physio or GP if the pain is very bad or isn’t getting better.

Self-help for shin splints

You can do lots of things yourself to treat shin splints. These self-help measures may help if you have a mild stress fracture as well, but with guidance from a physiotherapist or GP.

  • Stop doing the activity that caused your shin splints and rest for a few weeks. If you have a stress fracture, this can take up to 12 weeks to heal properly. Keep yourself active during this time by doing 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, as long as these are suitable for you.
  • 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 at a time. You can do this every two to three hours during the day if you need to.
  • Check your trainers or sports shoes to make sure they’re giving your feet enough support and cushioning. Specialist running shops can give you advice and information. Shock-absorbing insoles for your shoes may help to cushion your feet when you run.
  • When you start exercising again, start slowly. If you get shin splints again, stop the activity and rest for a few days before starting the exercise at a lower level of intensity. Build up the amount of exercise you’re doing gradually.
  • Run on a soft surface such as grass or a treadmill, rather than on hard roads.
  • Speak to your physiotherapist about changing your running style, as this may help.

It’s important to pay attention to your body. So, find a level of exercise that it can tolerate and slowly build on that, while allowing your shin enough time to heal.

Other treatment for shin splints

You should be able to treat your shin splints if you get enough rest. A physiotherapist can show you the best way to gradually increase your level of activity once the pain has gone.

Massaging and stretching can be helpful for shin splints. Your physiotherapist may recommend seeing if these help to ease your symptoms.

A podiatrist can make you orthotic insoles for your shoes. These insoles may be able to change the way you walk or run, if this could be causing your shin splints.

For information on treating stress fractures, see our FAQ on Do I need a cast for a stress fracture?

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. This may be caused by medial tibial stress syndrome (periostitis). Your bone and tissue can cope with a certain amount of impact, strengthening themselves each time so they can recover. 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 overweight or have big calves
  • you’ve just started doing a vigorous activity such as running after doing very little exercise
  • 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 or don't have enough cushioning and support, especially if you have flatter feet
  • you’ve changed your running pattern or the surface that you run on – such as from a treadmill to the road
  • you don’t rest enough between your exercise sessions so your muscles get very tired and your bones can’t recover

Prevention of shin splints

You may be able to reduce your chances of getting shin splints and stress fractures if you start a new exercise regime slowly. Build up gradually and make sure you have enough time to rest and recover between exercise sessions.

There are lots of other ways to try to prevent shin splints too. Some of these may help to prevent stress fractures as well.

  • Wear sports shoes or trainers that cushion and support your feet properly. This will depend on the shape of your foot, so it’s a good idea to get your running shoes fitted at a specialist running shop.
  • Trainers lose their ability to absorb shock after a while, which may make you more likely to get shin splints or stress fractures. Replace your trainers after 300 to 700 miles.
  • When you start an activity, or get back to one after a period away, build up the intensity gradually.
  • Wear cushioned insoles to absorb some of the impact when you’re running or playing sport. And wear orthotic shoe inserts if your doctor or physiotherapist recommends them.
  • Train and exercise on grass, if possible, and not always on hard surfaces, such as roads.
  • Do some stretching exercises for the front of your calves before you do any physical activities or sports.

Frequently asked questions

  • If you have a stress fracture, simply resting your leg may help to ease your symptoms. You can also use ice packs to relieve any swelling and painkillers to ease any pain. But sometimes your doctor or physiotherapist may ask you to wear a supportive brace, splint, walking boot or cast to help the fracture heal.

    Your doctor may recommend a cast if you can’t avoid the activity that caused your stress fracture in the first place. But doctors don’t routinely recommend a cast for stress fractures because it can weaken your muscles and bone. You may be advised to walk with crutches for a while instead.

    You should get back to putting your full weight on your leg as soon as possible, once the pain has gone. Physiotherapy can help to strengthen your muscles.

  • It can be frustrating if you have to stop an activity that you enjoy. But you really do need to rest for a few weeks, so your leg can recover. If you don’t rest enough, you it may take longer to recover fully.

    You’ll need to stop doing the activity that caused your shin splints, such as running, until the pain has gone. But this doesn't mean you have to give up exercise completely. You can keep yourself fit and active by doing sports that don't put any strain on your shins, such as swimming or cycling.

    Once your shins stop hurting, you can gradually start your training or activity again. Build up the amount and the intensity slowly. If your symptoms come back, stop the activity and rest for a few days before starting the exercise at a lower level of intensity.

    Ask your physiotherapist or GP about the safest way to get back to your previous levels of activity.

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  • Reviewed by Graham Pembrey, Lead Editor, Bupa Health Content Team, March 2019
    Expert reviewer, Dr Adrian Raby, General Practitioner
    Next review due March 2022