Shin Splints: Causes, Treatment and How to Prevent Them Coming Back

Shin splints, also known as medial tibial stress syndrome (MTSS), are a common overuse injury causing pain along the inner edge of the shinbone. They're especially prevalent in runners and anyone taking part in high-impact activities like dancing or jumping, and they typically result from excessive stress on the lower leg's tissues. Understanding what causes shin splints, how they're diagnosed, and how to treat them properly is key to a full recovery and avoiding a repeat injury.

What Causes Shin Splints?

Shin splints develop when the muscles and connective tissue around the shin bone are overloaded faster than they can adapt. The main contributing factors include:

Training errors. Rapid increases in training intensity, duration, or frequency without proper conditioning are one of the most common contributors. Adjusting training loads gradually helps avoid this type of overuse injury.

Muscle weakness. Weak calf muscles are strongly linked to MTSS. Building calf strength, aiming for calf raises equal to around 1.5 times body weight for five repetitions on a single leg, helps support and protect the shin.

Biomechanical issues. Poor running technique, including overstriding or inefficient gait mechanics, can place excessive load on the tibia and increase the risk of shin splints.

Improper footwear. Wearing shoes that are too stiff can increase strain on the calf and Achilles tendon. Rotating between pairs of shoes also helps vary the stimulus on the lower leg during training, which can reduce your risk of MTSS.

How Are Shin Splints Diagnosed?

A proper diagnosis usually involves a few key steps:

Subjective examination. Your physiotherapist will ask about your pain, running history, footwear choices, and strength training routine to help identify potential causes.

Objective examination. This involves palpating the affected area and running through a series of special tests to rule in or rule out specific conditions and assess the function of the lower leg.

Running assessment. Depending on your pain levels, a running assessment may be used to evaluate your gait mechanics and identify any biomechanical issues contributing to your symptoms.

Imaging, if necessary. Shin splints don't typically require imaging to diagnose, but in some cases an X-ray or MRI may be recommended to rule out other issues such as a stress fracture, particularly if pain is sharp, localised to one spot, or persists at rest.

How We Treat Shin Splints

Our approach to treating MTSS focuses on addressing the root cause, not just settling the pain:

Understanding your condition. We provide clear education about MTSS and what recovery looks like, including a realistic timeline and the steps needed to heal properly. In some cases, a temporary period away from running may be recommended to prevent the condition progressing.

Targeted manual therapy. Hands-on techniques are used to release tightness in the calf, ankle, and surrounding muscle groups, helping relieve tension that contributes to shin pain.

Tailored strength program. A customised program focusing on calf and lower leg strength helps prepare your body to handle the demands of running and reduces the risk of the injury recurring.

Footwear advice. Personalised recommendations on footwear suited to your gait pattern can make a real difference to both recovery and long-term performance.

Can Shin Splints Be Prevented?

Most cases of shin splints are preventable with the right approach:

• Increase training load gradually rather than jumping into higher volumes too quickly

• Build calf and lower leg strength as part of your regular training

• Rotate footwear and avoid relying on overly stiff shoes

• Address biomechanical issues early with a running assessment

• Warm up properly and include mobility work for the ankles and calves

When to Get It Checked

If shin pain is limiting your training, not settling after a few days of rest, or keeps coming back, it's worth getting it properly assessed rather than pushing through. Early treatment leads to a faster, more complete recovery and lowers the chance of it becoming a chronic issue.

Book an assessment with our team at Urban Physiotherapy to get to the bottom of your shin pain. Call us on (02) 8526 4000.