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Shin Splints(Medial Tibial Stress Syndrome): Fix It Fast — Without Sitting Out

  • Writer: Murray Leyland
    Murray Leyland
  • Dec 2, 2020
  • 5 min read

“Do I have to completely sit out with shin splints?”

I was just with a patient who asked me exactly that.


Short answer: usually no. Motion is lotion—but it has to be the right motion. We’ll dial down impact, keep your engine ticking over, and build you back smarter.




Quick Answer

Most “shin splints” are Medial Tibial Stress Syndrome (MTSS) — an overload issue along the inside edge of your shin.

The winning formula isn’t a full shutdown. It’s relative rest (swap high-impact for low-impact), calf/foot and hip strength, supportive footwear, and a graded return-to-run.


If pain is sharp and pinpoint, wakes you at night, or worsens as you run, you need urgent physiotherapy assessment to rule out a stress fracture.


"Rehab is a marathon, not a sprint. Consistency builds amazing outcomes at the end of rehab."


What are shin splints?

Plain English

Shin splints = irritation of bone and surrounding tissues where muscles attach along the medial (inside) border of your tibia. It often shows up after a sudden spike in training—more hills, harder sessions, new surfaces, or coming back too fast. Symptoms are typically a dull, diffuse ache over a few centimetres rather than one pinpoint spot.


Common symptoms

  • Achy, diffuse tenderness along the inner shin (often 5–10 cm)

  • Stiff at the start, eases as you warm up, then bites again after

  • Soreness with finger-pressure along a broad area


⚠️ RED FLAGS — GET ASSESSED

  • Focal (coin-sized) tenderness or pain that ramps up as you run

  • Night or rest pain, swelling, or a limp

  • Recent big training spike, low energy availability, menstrual changes

    Shin Splints location

Authoritative guidance: AAOS OrthoInfo, HealthDirect, Mayo Clinic, RACGP.



Evidenced-based relief strategies

Keep moving — just move smart. Rehab is a marathon, not a sprint.


  1. Activity modification (not full rest) 🏃‍♂️

    Swap impact for bike, swim, or elliptical. Keep sessions in the diary, trim intensity/duration, and respect the 24-hour rule (if it grumbles tomorrow, you did too much today). Sources: Mayo Clinic, Systematic review

  2. Ice for comfort 🧊

    15–20 minutes, several times/day, towel barrier on skin. Helpful early on to settle symptoms. Sources: HealthDirect, AAOS OrthoInfo

  3. Compression 🧘

    Sleeves or elastic bandage can reduce ache while you re‑load gradually. Sources: AAOS, Review

  4. Pain relief (short-term, as directed) 💊

    NSAIDs can help early, but they’re a bridge — not the plan. Source: Mayo Clinic

  5. Strength & mobility (can’t go wrong getting strong) 💪

    • Calf complex: straight-knee (gastroc) + bent-knee (soleus) raises

    • Foot control: tibialis posterior work, short-foot, big-toe pressure in heel raises

    • Hips/core: step-downs, split squats, side-plank hip abduction

    • Mobility if limited: ankle dorsiflexion rocks

      Good overviews: MedlinePlus, Exercise ideas, ModPod

  6. Footwear & (when needed) orthotics 👟

    Fresh, appropriate shoes and gradual shoe changes help reduce tibial load. Orthotics can help specific mechanics — they’re an adjunct. Sources: Cleveland Clinic, HealthDirect, AAOS, Review

  7. Graded return 📈

    Build slowly, one dial at a time (volume or hills or speed). Sources: ChoosePT, AAOS



 Treatments from Health Professionals

Tailored Care for Optimal Performance.

When self-care stalls, we add precision.


Targeted physiotherapy:

Load mapping, strength progressions (soleus/foot/hip), manual therapy and taping to settle symptoms while capacity grows.


Running technique analysis:

Video-based gait review to reduce tibial loading (e.g., slight cadence lift, reduce over-striding, improve hip–knee control). This not only unloads the shin — it often improves speed and economy when layered with strength and smart programming.


physiotherapist treating a shin splints


 Return-to-run roadmap

This is highly variable—it depends on your previous running level, experience, and pain irritability.


Starting framework (symptom-led):

  • 4 min easy jog / 2 min walk × 3–4 sets

  • No consecutive running days initially. Cross-train or rest between run days.

  • Progress by adding one extra set or extending the jog interval (e.g., 5–6 min) only if pain stays ≤3/10 during and settles within 24 hours, with no limp. If symptoms bump above that or linger the next day, step back to the last comfortable level

Technique cues while building back:

  • Cadence up ~5–7% (shorter, quicker steps)

  • Foot strike under hips (avoid over-striding)

  • Quiet, light landings



 Prevention that actually works

Keep it boring, keep it consistent.

  • Gradual load progressions: Nudge mileage or intensity up, don’t yank it. Avoid back-to-back hard days.

  • Strength on repeat: Soleus/gastroc raises, tibialis posterior/foot intrinsics, plus hip control. Can’t go wrong getting strong.

  • Rotate the stress: Mix surfaces (track, trail, road) and keep sharp hill spikes in check.

  • Footwear hygiene: Replace tired shoes regularly; make shoe changes gradual.

  • Warm-up that matters: Calf/ankle prep, easy strides, then go.

  • Recover like it’s training: Sleep, fueling, hydration. The simple stuff prevents the silly injuries.Helpful guides: AAOS, HealthDirect, ChoosePT.



⚠️ When to see a physio?

  • Pain hasn’t improved after 2–3 weeks of smart load tweaks

  • You’ve got focal, pinpoint tenderness, night/rest pain, swelling, or a limp

  • Recurrent shin pain every time you ramp up

  • You’ve got an event on the horizon and need a safe but faster plan


If pain is sharp and pinpoint, wakes you at night, or worsens as you run, you need urgent physiotherapy assessment to rule out a stress fracture. (We’ll map load, strength, footwear and do a running technique analysis to get you back on track.)


physiotherapists - Murray and Matthew from Thornton Physiotehrapy


 FAQS

  1. Do I have to stop running completely?

    Usually no. Switch to low-impact work and follow the 4-on/2-off walk–run start. Progress only if pain is ≤3/10 and settles in 24 hours. See: Mayo Clinic, Systematic review

  2. How long does recovery take?

    Simple cases can settle in 3–6 weeks with consistency. Complex or stress injuries take longer. Symptom-led, not calendar-led. See: AAOS

  3. Shin splints vs stress fracture — how do I tell?

    Shin splints = diffuse tenderness over a few cm.

    Stress fracture = focal, coin-sized pain, often sore at night or at rest.

    If that’s you, urgent physio assessment to rule out a stress fracture.

    See: RACGP, HealthDirect

  4. Will new shoes or orthotics fix it?

    They help the loading environment but won’t replace strength and smart progression. Use as adjuncts, not the whole plan.See: Cleveland Clinic, AAOS

  5. What are the best exercises?

    Bent-knee and straight-knee calf raises, tibialis posterior/foot intrinsic work, and hip control (step-downs/split squats). Sprinkle in ankle mobility if limited.See: MedlinePlus, Exercise ideas



Want Fast, Safe Relief from Shin Splints?

We’ll assess, guide, and build a plan that gets you moving again with confidence. Send us a message and we’ll lock in your appointment.

Book your appointment with Thornton Physiotherapy

Your Personal Best, Our Priority.


Murray Leyland, director of Thornton Physiotherapy.


Murray Leyland

Director, Thornton Physiotherapy





🎥 Didn’t catch the video earlier? Watch the video here.



References


  1. MedlinePlus. (n.d.). Shin splints – self-care: Patient instructions. U.S. National Library of Medicine. https://medlineplus.gov/ency/patientinstructions/000654.htm MedlinePlus

  2. The Feet People. (2022, April 1). Best shin splints exercises & stretches. https://www.thefeetpeople.com.au/learning-hub/best-shin-splints-exercises-and-stretches/ The Feet People

  3. ModPod Podiatry. (n.d.). 5 effective treatments for shin splints. https://www.modpodpodiatry.com.au/5-effective-treatments-for-shin-splints/ ModPod Podiatry

  4. Cleveland Clinic. (n.d.). Shin splints: Symptoms, causes & treatments. https://my.clevelandclinic.org/health/diseases/17467-shin-splints Cleveland Clinic

  5. ChoosePT. (n.d.). 8 tips to prevent shin splints. https://www.choosept.com/health-tips/8-tips-prevent-shin-splints choosept.com

  6. Fallon, K. (2023, November). Shin pain in athletes. Australian Journal of General Practice, 52(11). https://www1.racgp.org.au/ajgp/2023/november/shin-pain-in-athletes Mayo Clinic+1

  7. American Academy of Orthopaedic Surgeons. (n.d.). Shin splints. OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/shin-splints/ OrthoInfo

  8. healthdirect Australia. (2024, November). Shin splints – symptoms, causes, treatment & diagnosis. https://www.healthdirect.gov.au/shin-splints Healthdirect

  9. Mayo Clinic Staff. (2025, April 30). Shin splints – diagnosis & treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/shin-splints/diagnosis-treatment/drc-20354110 Mayo Clinic

  10. Fallon, K. (2023, November). Shin pain in athletes. Australian Journal of General Practice, 52(11). https://doi.org/10.31128/AJGP-03-23-6767 RACGP

  11. Bhusari, N., & Deshmukh, M. (2023, January 18). Shin Splint: A review. Cureus, 15(1), e33905. https://doi.org/10.7759/cureus.33905 pmc.ncbi.nlm.nih.gov



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