Summary

Shin splints, also called medial tibial stress syndrome, describe pain along the front or inner edge of the lower leg. It is a common overuse injury caused by repetitive stress on the lower leg. For this reason, it is prevalent in runners, affecting 13.6% to 20% of runners. Because running is part of the HYROX competition, those training for it may also suffer.

The White House Clinic provides physiotherapy for patients with shin splints at our 14 locations across South Yorkshire, North East Derbyshire and Nottinghamshire. Our physiotherapists can assess the cause of shin splints and create a personalised treatment plan designed to reduce symptoms, restore movement and help prevent the condition from returning.

An overview of shin splints

Shin splints or shin pain is clinically referred to as medial-tibial stress syndrome (MTSS). It is an umbrella term that often refers to a number of issues involving pain in the shin area. 

At their worst, shin splints can turn into a stress fracture along the tibia, and searing pain will be felt with every stride. In less severe cases, the muscles and tendons in the shin area may be tender and inflamed, or even develop micro tears near their attachment to the tibia (shin bone); often pain lessens a few miles into the run and builds up again towards the end of a run or afterwards. Either way, shin pain is a sure-fire way to make your running experience markedly unenjoyable and accounts for approximately 15% of running injuries.

The condition affects the tissues surrounding the tibia, the large bone at the front of the lower leg. Muscles and connective tissue attach to this bone and help control movement during walking, running and jumping.

Shin splints symptoms

The most common symptom is pain along the shin bone during or after exercise.

People with shin splints may notice:

• Pain along the front and medial (inner) side of the tibia (shin bone).
• Mild cases - pain after running. Symptoms which may improve with rest but return with activity
• Moderate cases - pain on impact as foot strikes the ground.
• Severe cases - pain standing or just walking without any impact.
• Pain on palpation along the inside edge of the tibia. Pain when squeezing/compressing the calf muscle and anterior shin together.
• Mild swelling along the lower leg

Causes of shin splints

Shin splints usually develop when the lower leg is under repeated stress.

This can happen if the muscles, tendons and bone tissue in the shin are irritated or overloaded. Shin splints can develop after sudden increases in training volume or intensity as the tissues are unable to cope with the new demands.

Common contributing factors include running on hard surfaces, wearing unsupportive footwear, or increasing activity levels too quickly. Tight calf muscles, reduced ankle mobility, and lower-limb weakness can also increase strain on the shin.

We often see shin splints in people who have recently started a new exercise routine or who have returned to activity after a break. While it’s common in runners, HYROX competitors, tennis players, and football players are also at risk.

When to see someone for shin splints

Will shin splints go away on their own? Often, with rest and activity modification, they do improve. However, you should consider seeking professional advice if lower-leg pain from running or training persists, worsens, or begins to affect your ability to train or walk comfortably. Address symptoms early to reduce the risk of more serious bone stress injuries developing.

At the White House Clinic, you don’t need a referral to book a physiotherapy appointment for your runner’s shin pain. This gives you faster access to expert care and a speedier return to sport.

Physiotherapists at the White House Clinic can assess the cause of the pain and identify factors such as movement patterns, muscle weakness or training load that may be contributing to the condition.

What to do if you have shin splints

If you develop shin splints, reduce activities that cause pain. Replace high-impact activities, such as running, with lower-impact options while the tissues heal. A physiotherapist can show you exercises to improve strength and mobility in the lower leg, ankle and hips. Addressing these areas can help reduce strain on the shin, support a safer return to running or sport and prevent recurrence.

Treatment for shin splints

Management usually focuses on reducing aggravating activity and supporting recovery through rehabilitation and gradual return to exercise.

Rest, ice, and ibuprofen (non-steroidal antiinflammatories) should be considered in the early stages to ease the pain.

Physiotherapy

Physiotherapy focuses on addressing both the symptoms and the underlying causes of shin splints.

A physiotherapist will assess how you move, your muscle strength and flexibility, and they will consider how your activity levels have changed. Based on this assessment, they can develop a progressive rehabilitation programme to support recovery.

Rehabilitation may focus on improving lower-limb strength, restoring flexibility, and gradually increasing tolerance to activity. A physiotherapist will provide guidance for runners and individuals involved in high-intensity gym training or HYROX, to help manage training volume and intensity.

Physiotherapy including mobilisation, massage, taping and acupuncture can all promote tissue healing, symptom relief and help mobilise surrounding tight structures. 

Common exercises that are recommended in the management of shin splints are:

• Leg Swings to the side with exercise band
• Calf raises one leg
• Big toes flexion with exercise band
• Supine bridge or single leg bridge
• Full wall squat
• Bosu ball squats on single leg

Your physiotherapist will provide the best exercises that are specific for your rehabilitation and ensure you are performing them with the correct technique for maximum benefit.

Shockwave therapy

Shockwave therapy is a non-invasive treatment sometimes used for persistent musculoskeletal conditions. The treatment uses sound waves to stimulate the affected tissue, promote healing, improve blood flow, and encourage recovery.

Who’s affected by shin splints?

Shin splints are common among people who regularly take part in activities involving repetitive impact on the lower legs. Runners, people returning to exercise after a break, and those who suddenly increase the intensity or frequency of training can get shin splints.

People with tight calf muscles, limited ankle mobility, or poor lower-limb strength may also be more likely to experience shin splints.

Reducing the risk of shin splints happening again

To prevent shin splints from recurring, it’s important to gradually increase training volume and intensity, wear appropriate footwear, and maintain lower-limb strength and flexibility.

Following a structured rehabilitation plan from a physiotherapist can help you return to activity safely and provide you with the knowledge to reduce the risk of shin splints coming back.

Your physiotherapist may consider and discuss having a run analysis at the White House Clinic in order to identify any movement patterns which may be contributing to the injury and to recommend ways to fix these.

References

• ‍NCBI
• ‍NHS
• ‍Runner’s World‍