A Runner’s Complete Guide to Shin Splints

There are few things more frustrating to any runner than battling an injury. Sometimes, it can seem that just as everything has finally been clicking in your training and you’ve been consistently nailing your workouts, you get sidelined by an ache or pain that just won’t go away. Because running is a high-impact activity, injuries are unfortunately common, and shin splints are among the most common overuse injuries runners face, particularly if new to the sport or otherwise ramping up mileage too quickly. However, by understanding what shin splints are and implementing some preventative measures, you can arm yourself to catch the warning signs before a full-blown injury develops. That way you can stay out on the roads, enjoying mile after mile.

What Are Shin Splints?

Shin splints, also referred to as medial tibial stress syndrome, is an overuse injury characterized by nagging pain along the front (anterior) portion of your shin, typically towards the inside of the tibia bone. The pain usually increases with activity and subsides with rest, and is worse going down hills or running on particularly hard surfaces such as concrete and asphalt. 

When the case of shin splints is still mild, the you may find that the pain is present at the beginning of a run, but subsides after a few miles when the muscles have warmed up. You may also feel pain if you press along the length of the bone, and it may be in one or both legs. The pain can also be towards the outside of the tibia, though this is less common.

The pain from shin splints is usually due to inflammation and small tears in the muscles along the tibia—namely tibialis anterior and to a lesser extent, tibialis posterior—due to improper technique or overuse. If not addressed, shin splints can progress to a tibial stress fracture.

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What Causes Shin Splints?

Shin splints result from damage to the muscles controlling the ankle and arch, typically from one of three main causes: overuse and overly aggressive training, poor technique, or improper footwear.

How overtraining can cause shin splints.

Beginner runners or those returning from an injury or break who increase their mileage too quickly are at risk for developing shin splints. It takes time for the body to adapt to the impact and stress of running.

When you run, the muscles experience micro tears. These are innocuous when balanced with adequate rest and recovery, because the muscle fibers are able to heal and strengthen between runs. However, ramping up mileage, speed, or intensity in terms of the hilliness of the terrain too quickly can cause more significant tears or prevent the normal micro tears in the tibialis anterior from healing between workouts. As a result, the damage progresses, inflammation and weakness occurs, and you’ll feel the dreaded throbbing pain along the bone.

It’s important to gradually increase your mileage—whether a new or seasoned runner—to give your body time to recover and adapt. The general recommendation is to increase your mileage by no more than 10% per week, but it’s also vitally important to progress the intensity gradually as well.

How form can affect shin splints.

Overuse to the shin muscles can also occur if your biomechanics are faulty.

Heel striking, for example, places excessive stress on the tibialis anterior because it causes rapid and repeated stretching of the muscle by taking it from the shortened, contracted state to a fully stressed state over and over.

Overpronation refers to a foot that rolls inward more than 15 degrees upon landing. This ankle rotation causes the anterior tibialis to do more work by directing the bulk of the propulsion forces on the big toe. 

Footwear is a factor, as well.

Getting your gait analyzed to ensure you have the proper footwear and/or orthotics can correct some of the biomechanics issues mentioned above.

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Preventing and Treating Shin Splints

Preventing shin splints centers around progressing mileage and intensity gradually, wearing the proper shoes, and strengthening the muscles of the lower leg, ankle, and foot. 

If you already have shin splints, the sooner you can start addressing the injury, the quicker and more successful your recovery should be. It can be possible to train through shin splints—with some modifications—especially if you are able to identify the root cause (i.e., training errors, improper footwear, or running form issues). Here are some other helpful guidelines and tips to follow to treat shin splints and get you back to running pain free:

• Ice. Ice your shins for 10-15 minutes several times per day to reduce inflammation.
• Run on softer surfaces. Running on grass, trails, cinder, or rubberized tracks is more forgiving and puts less stress on your body than concrete and asphalt. That said, don’t immediately jump to soft surfaces for all your muscles if you’ve only been hitting the roads because this can be too taxing for your feet and ankles. Instead, try to run at least half of your miles on softer surfaces.
• Reduce your mileage. No runner wants to hear this, but it’s usually necessary in the acute phase of any injury to cut back your running, at least until you’re not feeling pain during the run.
• Cross-train. The good news is that you can substitute low-impact cross-training activities like cycling, swimming, pool running, rowing, and elliptical trainers for running. This will reduce the usual, repetitive stress on your muscles while still permitting a good cardiovascular workout.
• Strengthen your lower leg. Strengthening your calves, shins, and arches can help prevent and treat shin splints. Calf raises, heel walks, drawing the alphabet with your foot, and picking up marbles or small objects with your toes can develop strength in the tibialis anterior and reduce the risk of getting shin splints.
• Stretch. Stretching your calves and using a foam roller or lacrosse ball along the muscle can also help prevent further damage and aid recovery.

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Above all, listen to your body. If you’re feeling shin pain, it’s worth it to do a mental audit to identify the root cause to ensure you can address and correct the issues before you’re sidelined with the relentless discomfort of shin splints.