Shin Splints in Runners: An Evidence-Based Guide to Recovery and Prevention
- cliftonpurephysio
- 15 minutes ago
- 4 min read
If you’re have set yourself a goal this year to complete a 5km, 10km, a half or full marathon and started running again after a few months off or are a first time runner, chances are you’ve felt it. It feels like a dull, aching pain along the front or inside of your shin/ lower leg that creeps in during a run and sometimes lingers long after. “Shin splints” is one of the most common running injuries, and also one of the most misunderstood.
As a physiotherapist working with runners, I’ll say this this, shin splints are very treatable, and in most cases completely preventable, when you address the real causes rather than just the symptoms. However, not all shin pain is the same. It is important that a Physio has diagnosed you with "shin splints"or medial tibial stress syndrome before following the advice below, as it may be a number of other injuries such as stress fractures, tendon overload, or compartment-related issues that are causing the pain.
What are Shin Splints?
“Shin splints” is the umbrella term for Medial Tibial Stress Syndrome (MTSS). It refers to pain along the tibia (shin bone), usually on the inner border, caused by repetitive loading that exceeds the bone and surrounding tissue’s ability to adapt.
This is not inflammation of the shin bone itself, and it’s not something you just have to “run through.”
Why do novice and intermediate runners get Shin Splints?
The strongest research points to training load errors as the primary driver. In plain terms: doing too much, too soon.
Common contributing factors include:
1. Rapid increases in running load
Sudden jumps in distance.
Adding speed work or hills too quickly.
Increasing frequency without adequate recovery.
Bone adapts slower than muscles and cardiovascular fitness. Your fitness may feel ready, but your tibia might not be.
2. Reduced load tolerance
Research consistently links MTSS with:
Lower calf strength and endurance.
Poor single-leg control.
Reduced ankle and foot load-handling capacity.
This doesn’t mean you’re “weak”, it means the tissues aren’t conditioned for your current running demands yet.
3. Previous injury history
A prior episode of shin splints significantly increases the risk of recurrence, usually because the underlying causes weren’t fully addressed the first time.
4. Footwear and surface changes
Shoes don’t cause shin splints, but sudden changes such as new shoes, minimal footwear, or more uneven slanted surfaces can spike load quickly.
The evidence-based approach to treating Shin Splints
The gold-standard management approach focuses on graded loading, not complete rest.
1. Modify load
Complete rest is rarely needed unless pain is severe or constant.
Instead:
Reduce weekly volume by ~20–40%
Temporarily remove speed work and hills
Keep runs pain-free or low-pain (≤3/10 during, settles within 24 hours)
Bone responds best to controlled, progressive load, not zero load.
2. Progressive strength training
Strong evidence supports strengthening as a core component of rehab.
The calf muscles play a major role in absorbing and redistributing impact forces away from the tibia.
A detailed tailored exercise programme provided by your Physio will target the foot and ankle loading along with hip and trunk stability, that will improve your running efficiency.
3. Bone specific loading progressions
Once walking and easy running are pain-free, then gradually introduce different factors, which our physiotherapist will adjust for you. Skipping stages is one of the biggest reasons shin splints return.
How physiotherapy helps Shin Splints?
While shin splints are common, and can get better by the information above. However if the pain lingers or keep coming back, then it's time to see a physio.
1. Accurate Diagnosis
Like I mentioned above not all shin pain is the same.
A physiotherapist will:
Differentiate medial tibial stress syndrome from stress fractures, tendon overload, or compartment-related pain.
Identify whether the issue is primarily bone load, muscle fatigue, or poor force distribution.
Screen for red flags that should not be run through.
This matters because treating the wrong condition wastes time, and risks a more serious injury.
2. Identifying your load problem
Shin splints aren’t caused by one thing. They are caused by how load is applied to your body.
In clinic, this means:
Assessing running history, recent changes, and recovery habits.
Evaluating calf strength, endurance, and asymmetry.
Looking at single-leg control, hopping tolerance, and ankle stiffness.
Reviewing footwear and training surfaces in the context of Mallorca’s terrain.
3. Individualised, progressive rehab
The research has shown that graded loading works, but only when it’s dosed correctly.
Physio rehab includes:
A structured return-to-running plan.
Progressive calf and lower-limb strengthening matched to symptoms.
Clear guidelines on what pain is acceptable and what isn’t.
Objective markers to progress intensity, hills, and speed safely.
This removes the uncertainty that keeps many runners stuck in the “rest → flare-up → rest” cycle.
4. Hands-on treatment
Manual therapy doesn’t “fix” shin splints, but it can help help reduce the pain, and get you to the race line quicker.
Physio treatment may include:
Soft tissue techniques to reduce excessive muscle tone.
Joint mobilisation to improve ankle and foot mechanics.
Pain strategies to allow continued movement and loading.
How long does recovery take?
With the right approach:
Mild cases: 2–4 weeks.
Moderate cases: 6–8 weeks.
Chronic or recurrent cases: longer, but still very manageable.
The timeline depends less on how long you rest, and more on how well you rebuild load tolerance.
Why does early Physio input makes recovery faster
Runners who seek physiotherapy early tend to:
Return to running sooner.
Have fewer recurrences.
Avoid progression to stress fractures.
Gain confidence in managing future training loads themselves.
Shin splints are not something you need to “push through,” and they’re not something that should keep coming back year after year.
With the right physiotherapy approach, that is focused on diagnosis, progressive loading, and long-term resilience, most runners recover fully and return stronger than before.
If you’re running in Mallorca and dealing with persistent or recurring shin pain, working with a physiotherapist such as Síofra from Clifton Pure Physio, who understands running biomechanics, bone stress injuries, and evidence-based rehab can make all the difference.
Comments