Medial Shin and Inner Ankle Pain. What Runners Need to Know?
- cliftonpurephysio
- 20 hours ago
- 3 min read
If you’re a runner experiencing pain along the inside of your shin or around the inner ankle, you’re not alone. Medial shin pain is one of the most common injuries we see in runners at Clifton Pure Physiotherapy, particularly in those training for events, increasing mileage, or returning to running after a break. While many runners assume it’s simply “shin splints”, medial shin and ankle pain can have several different causes, and understanding the exact source is key to recovering quickly and preventing it from coming back.
In this blog we’ll explain:
Why runners develop inner shin and ankle pain
The most common running injuries causing it
Signs you should see a physiotherapist
How a specialist running physio can help you get back to running pain-free
Why Do Runners Get Pain on the Inside of the Shin or Ankle?
Running places repeated load through the lower leg, especially through the tibia (shin bone) and the tendons supporting the arch of the foot.
Normally the body adapts to this stress. But when training load increases faster than the body can adapt, the tissues become overloaded.
Common triggers include:
Increasing mileage too quickly
Adding hills or speed work suddenly
Changing running shoes
Returning to running after time off
Training for a race
When this happens, the structures along the inside of the shin and ankle can become irritated.
The Most Common Causes of Medial Shin Pain in Runners
1. Shin Splints (Medial Tibial Stress Syndrome)
The most common cause of medial shin pain is medial tibial stress syndrome, often referred to as shin splints.
Typical symptoms include:
A dull ache along the inner shin
Pain during or after running
Tenderness along a long section of the shin bone
Symptoms that improve with rest but return when running resumes
Shin splints usually develop when the bone and surrounding tissues are overloaded repeatedly during running.
2. Posterior Tibial Tendon Irritation
Another common source of pain is irritation of the posterior tibial tendon, which runs behind the inner ankle and supports the arch of the foot.
Symptoms often include:
Pain behind the inner ankle bone
Pain spreading up the inside of the shin
Pain when pushing off while running
Arch fatigue or foot weakness
This tendon works extremely hard during running to control foot stability, particularly on hills or longer runs.
3. Tibial Stress Reaction or Stress Fracture
In some cases medial shin pain may represent a bone stress injury.
Signs that this may be more serious include:
Pain that becomes more localised
Pain that worsens with every run
Pain during walking or daily activities
Tenderness over a very small area of the shin
These injuries require early assessment to prevent progression to a stress fracture.
When Should You See a Physiotherapist?
You should consider booking a physio appointment if:
Your shin pain lasts longer than 1–2 weeks
Pain returns every time you run
You have pain around the inner ankle
You’re training for a race and can’t afford downtime
Pain is getting progressively worse
Early treatment can often prevent a minor issue turning into a long-term running injury.
How Physiotherapy Helps Runners with this Pain?
At Clifton Pure Physiotherapy, we specialise in assessing and treating running injuries.
A physiotherapy appointment typically includes:
Detailed Running Assessment
We look at:
your training load
recent mileage changes
footwear
running surfaces
race preparation
Biomechanical Screening
We assess:
calf strength
hip control
foot stability
ankle mobility
Running Technique Analysis
Where appropriate, we may assess:
stride length
cadence
loading patterns
Individual Rehabilitation Plan
Treatment focuses on:
progressive strength training
load management
improving tissue capacity
gradual return to running
The goal is not just to reduce pain, but to help you run stronger and reduce future injury risk.
The Biggest Mistake Runners Make
One of the most common mistakes we see is trying to run through this pain.
Continuing to train on an irritated tibia or tendon can turn a manageable overload injury into a stress fracture, which may require months away from running.
Getting the right advice early can often keep you running while you recover.
Book a Running Injury Assessment at Clifton Pure Physio
If you’re experiencing medial shin pain, inner ankle pain, or recurring shin splints, our physios at Clifton Pure Physio can help identify the cause and guide your recovery.
Our team regularly treats runners training for:
marathons
half marathons
triathlons
local running events
Book a Physiotherapy Appointment
If shin pain is affecting your running, don’t ignore it.
Book an assessment with Clifton Pure Physio and get a clear plan to return to running safely.
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