That familiar ache along your shins after running? Here's how to fix it—and prevent it.

What Are Shin Splints?

The Medical Term

Medial tibial stress syndrome (MTSS): Inflammation and irritation where muscles attach to the shinbone.

What's Happening

The anatomy:

• Lower leg muscles attach along the tibia (shinbone)
• Repetitive stress irritates these attachments
• Inflammation develops along the bone

The result: Aching pain along the inner shin.

The Pattern

Typical presentation:

• Pain along inner shin (medial tibia)
• Covers several inches (not one spot)
• Both legs often affected
• Worse during or after running
• Better with rest

What Causes Shin Splints

Primary Causes

Training errors (most common):

• Too much mileage too fast
• Sudden increase in intensity
• Running on hard surfaces
• No rest days

Biomechanical factors:

• Tight calf muscles
• Weak lower leg muscles
• Overpronation
• Flat feet or high arches

Equipment:

• Worn-out shoes
• Wrong shoes for your foot type
• Sudden shoe changes

Risk Factors

Higher risk if:

• New to running
• Returning after time off
• Female (bone density differences)
• Running on concrete
• Previous shin splints

Treatment

Phase 1: Rest and Reduce Inflammation

Stop aggravating activity:

• Reduce or stop running
• Cross-train (swimming, cycling—no impact)
• Walk if tolerated

Manage inflammation:

• Ice for 15-20 minutes, several times daily
• Anti-inflammatories if appropriate for you
• Compression if comfortable

Phase 2: Strengthen and Stretch

Calf stretches:

• Gastrocnemius (straight leg)
• Soleus (bent knee)
• 30 seconds, 3 times each, daily

Strengthening exercises:

Calf raises:

• 3 sets of 15-20
• Progress to single leg

Toe raises:

• Stand, lift toes off ground
• 3 sets of 15-20
• Strengthens anterior tibialis

Heel walks:

• Walk on heels for 30 seconds
• Rest, repeat 3 times

Toe walks:

• Walk on toes for 30 seconds
• Rest, repeat 3 times

Phase 3: Gradual Return

When pain-free for several days:

• Start with short run/walk
• Soft surfaces preferred
• Monitor response

If pain returns:

• Back off immediately
• More rest needed

Prevention

Training Principles

The 10% rule:

• Increase weekly mileage by 10% maximum
• More conservative if returning from injury

Surface variety:

• Mix hard and soft surfaces
• Trail and grass when possible
• Avoid all-concrete training

Rest days:

• Essential for tissue adaptation
• At least 1-2 per week

Conditioning

Lower leg strength:

• Calf raises (bilateral and single leg)
• Toe raises
• Heel walks, toe walks
• Include 2-3 times per week

Flexibility:

• Regular calf stretching
• After every run

Footwear

Shoe considerations:

• Replace before worn out (300-500 miles)
• Appropriate support for your foot
• Gradual transitions to new shoes

When to See a Doctor

Warning Signs

See a doctor if:

• Pain localized to one specific spot (stress fracture concern)
• Pain doesn't improve with rest
• Pain while walking
• Night pain
• Swelling or warmth at specific area
• Pain lasting longer than 3-4 weeks despite rest

Stress Fracture vs. Shin Splints

If in doubt, get evaluated. Stress fractures require longer rest and monitoring.

Return to Running

Timeline

Typical return:

• Pain-free for 3-5 days
• Start with 50% normal volume
• Walk/run if needed
• Progress over 2-3 weeks

Return Protocol

Week 1:

• Run/walk 15-20 minutes
• Every other day
• Soft surfaces preferred

Week 2:

• If no pain, increase to 25-30 minutes
• Still alternate days

Week 3:

• Gradual return to normal
• Continue prevention exercises

Ongoing Prevention

After recovery:

• Maintain lower leg strength work
• Continue stretching routine
• Progress training conservatively
• React quickly if symptoms return

Shin splints are common but preventable. The solution is usually straightforward: reduce training load, strengthen the lower leg, and return gradually with smarter training practices. Most cases resolve within weeks when managed properly.

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