Shin Splints: Causes, Treatment and When to See a Physio

1What Shin Splints Actually Are

“Shin splints” is the everyday name for medial tibial stress syndrome: pain along the inner edge of the shin bone, usually in the lower half. It is an overload problem. The muscles that attach along the shin, and the bone itself, are being asked to handle more than they are ready for, and the lining of the bone becomes irritated.

It feels like a dull ache or tenderness along a stretch of the bone rather than one exact spot. Typically it hurts at the start of a run, may ease as you warm up, and comes back afterwards or the next morning. Runners, netball and football players, dancers and people who have just started a new fitness programme are the most commonly affected.

2Common Causes

Shin splints rarely have one cause. The usual culprits are:

• A jump in training. More kilometres, more sessions, hills or speed work added too quickly. This is the most common trigger by far.
• Surface changes. Moving from grass or trails to footpaths, or running on a sloped beach or road camber.
• Worn-out or unsuitable shoes for your running style and mileage.
• Calf and hip strength. Weak or tight calves and weak hip muscles mean the shin takes more of the load.
• Running technique. Overstriding and heavy heel striking increase the stress on the lower leg.
• Not eating enough for your training. Low energy intake can affect bone health, particularly in younger and female athletes.

3Shin Splints or a Stress Fracture?

Most shin pain in runners is shin splints, but it is worth knowing the signs of a stress fracture, which needs a different approach:

• Pain in one small, very tender spot on the bone, rather than along a longer stretch.
• Pain when you hop on that leg.
• Pain that is there when you are walking, resting or lying in bed at night.
• Pain that gets steadily worse even though you have cut back your running.
• Swelling over the painful spot.

If any of these sound familiar, stop running and get it assessed. A physio can examine the leg and refer you for imaging if a stress fracture is suspected.

4What You Can Do Now

• Reduce, don’t necessarily stop. Cut your running back to a level that does not bring the pain on, or swap some runs for cycling or swimming while it settles.
• Ice the sore area for 10 to 15 minutes after activity if it helps the ache.
• Check your shoes. Most running shoes are worn out somewhere between 500 and 800 km.
• Build back gradually. Once you can walk and hop without pain, return with short, easy runs on softer surfaces and increase slowly.
• Strengthen your calves. Simple heel raises, done regularly, are one of the most useful things you can do.

5How a Physio Treats Shin Splints

A sports physio will look at why the problem started, not just where it hurts. That usually means:

• Checking your training history and building a return-to-run plan that increases load at a pace your legs can handle.
• Assessing calf, foot and hip strength and flexibility, and giving you targeted exercises.
• Looking at how you run, including stride length and cadence.
• Hands-on treatment for tight calf muscles, and dry needling where it suits you.

Many runners also book regular sports massage during heavy training blocks to keep their calves in check. If your shin pain started with a specific incident, it may be covered by ACC, and your physio can lodge a claim if it is eligible. No GP referral is needed.

Shin Splints — Common Questions