Shin Splints: Understanding and Treating Medial Tibial Stress Syndrome
- My Family Podiatry
- Mar 17, 2021
- 8 min read
Updated: Mar 19
Shin splints are one of the most common lower limb complaints in runners, field sport athletes, gym-goers and people who have recently increased their training. The pain often starts gradually, usually along the inside of the shin, and may at first feel like something you can run through. Over time, it can become more persistent, more localised and more limiting.
At My Family Podiatry in Albany Creek, we regularly assess and treat shin pain in active adults, teenagers, school sport athletes and people returning to exercise after time away. While many people use the term shin splints as a catch-all diagnosis, the truth is that not all shin pain is the same. Understanding what is actually driving the pain is the key to treating it properly.
If you live in Albany Creek, Eatons Hill, Bridgeman Downs, Warner, Aspley or the wider North Brisbane area and are struggling with shin pain during walking, running or sport, this guide will help you understand what may be going on and what treatment options are available.
What are shin splints?
Shin splints is a broad term commonly used to describe pain along the shin, most often along the inner lower border of the tibia. In many cases, this pain relates to medial tibial stress syndrome, often shortened to MTSS.
MTSS is usually linked to repeated stress on the shin bone and the soft tissues that attach around it. It often develops when the body is exposed to more running, jumping or impact than it is currently prepared to handle.
That said, not all shin pain is medial tibial stress syndrome. Sometimes the pain is more muscular, sometimes it is linked to tendon overload, and in some cases a more serious bone stress injury needs to be considered.
This is why proper assessment matters. The label shin splints is common, but it does not tell the whole story.
What do shin splints feel like?
Most people describe shin splints as:
aching or soreness along the inside of the shin
discomfort during or after running
pain that starts early in activity and may ease as they warm up
tightness or tenderness in the lower leg
pain that becomes worse with increased training load
discomfort when jumping, sprinting or doing repeated impact activity
In milder cases, the pain may only appear after exercise. In more progressed cases, it may begin earlier in activity, linger for longer afterwards or even become noticeable during walking.
If the pain becomes very localised, severe or painful at rest, that raises more concern for a bone stress reaction or stress fracture rather than straightforward shin splints.
What causes shin splints?
Shin splints rarely happen because of one single factor. In most cases, they develop because the load going through the lower leg has exceeded what the tissues can currently tolerate.
Common contributors include:
Sudden increase in training load
This is one of the biggest reasons shin splints develop. It might be:
increasing running distance too quickly
adding sprint training
returning to sport after a break
starting HYROX, CrossFit or field sport preseason
doing more jumping or court work than usual
The tissues of the shin need time to adapt. If the load rises faster than that adaptation can occur, pain often follows.
Footwear issues
Shoes that are overly worn out, unsuitable for the activity, too minimal for the person using them, or simply not matching the person’s mechanics can all contribute to shin pain.
Poor load tolerance through the calf and lower leg
Calf weakness, reduced lower limb strength, poor single leg control and reduced tissue conditioning can all increase stress through the shin during impact.
Running mechanics and foot posture
Some people overload the shin because of the way they move. This might involve:
excessive pronation in some cases
poor shock absorption
lower limb asymmetry
poor control through the ankle and hip
inefficient running mechanics
It is important not to oversimplify this. Shin splints are not just caused by “flat feet”, but foot posture and lower limb mechanics can absolutely play a role.
Surface changes
A sudden change in training surface can be relevant too. Running more on hard surfaces, cambered roads, uneven grass or doing repeated sessions on a track can all alter the way force is absorbed through the leg.
Who commonly gets shin splints?
We commonly see shin splints in:
beginner runners
people training for a running event
teenagers in school sport
football and soccer players
basketball and netball players
dancers
gym-goers doing repeated jumping or sled work
adults returning to exercise after a long break
The condition is especially common in people who are motivated and trying to improve quickly. The problem is often not a lack of effort. It is that the tissues have not yet caught up with the amount of work being asked of them.
Is it definitely shin splints, or could it be something else?
This is one of the most important questions.
Pain along the shin may be due to:
medial tibial stress syndrome
muscle overload
tendon-related pain
compartment-related issues
a bone stress reaction
stress fracture
This matters because the treatment is not the same in every case.
If pain is becoming very localised to one spot, worsening despite rest, painful during walking, painful at night or painful at rest, it is important to consider whether the issue is more serious than typical shin splints. In some cases, imaging may be required to rule out bone stress injury.
How we assess shin splints at My Family Podiatry
At My Family Podiatry, we do not just look at where the pain is. We look at why the pain has developed.
A shin splints assessment may include:
discussion of training history and recent load changes
assessment of where the pain is located and when it occurs
palpation of the shin and surrounding tissues
footwear assessment
walking and running gait assessment where relevant
calf strength and lower limb capacity testing
foot posture assessment
review of previous injury history
discussion around recovery, training surfaces and gym load
Where indicated, we may also recommend imaging or liaise with your GP if the presentation suggests a possible bone stress injury rather than standard shin splints.
What actually helps shin splints?
The best treatment depends on what is driving the problem, but in most cases the answer is not complete rest forever, and it is not just stretching.
Effective treatment often includes a combination of the following:
1. Training modification
This is often the first step.
That does not always mean stopping completely, but it usually does mean reducing or modifying the activity that is repeatedly flaring the shin. This may include:
reducing running volume
temporarily avoiding speed sessions
modifying jumping drills
replacing some impact sessions with lower impact cardio
spacing out training more effectively
The goal is to reduce irritation while still keeping the person progressing where possible.
2. Footwear changes
The wrong shoe can absolutely keep shin pain going.
Some patients are training in shoes that are too old, too soft, too unstable or simply not appropriate for the type of training they are doing. Others are in very minimal shoes that their body is not yet conditioned for.
A proper footwear review can make a meaningful difference.
3. Strength and load capacity work
This is one of the most important long-term pieces.
Shin splints often improve when we build:
calf strength
lower leg endurance
single leg stability
hip strength and control
tissue tolerance to repeated impact
If strength and load capacity are ignored, symptoms often settle temporarily and then return the moment training ramps up again.
4. Orthotics where appropriate
Orthotics are not necessary for every case, but they can be very helpful when foot posture, excessive load through the medial side of the leg, or poor force distribution is part of the problem.
At My Family Podiatry, we only recommend orthotics where they are clinically justified, not as a blanket treatment for every runner with shin pain.
5. Shockwave therapy in selected cases
For stubborn shin pain, particularly when the soft tissues remain irritated and progress has stalled, shockwave therapy can sometimes be a useful part of treatment.
As with all treatments, this depends on the diagnosis. If there is concern for stress fracture or active bone stress injury, that requires a different approach.
6. Return-to-run guidance
One of the biggest mistakes people make is returning to running based on guesswork. They rest until the pain settles, then go straight back to their previous training level and flare it again.
A better return-to-run plan is gradual, structured and based on symptom response.
Why shin splints often keep coming back
Shin splints tend to recur when the pain is treated, but the underlying cause is not.
This commonly happens when:
training increases too quickly again
the person returns in the same shoes
no strength work has been done
lower limb asymmetry has not been addressed
the diagnosis was not fully accurate in the first place
This is why a proper assessment matters. Temporary rest may calm it down, but it does not tell you what needs to change.
What happens if you ignore shin splints?
Some mild cases improve with training modification and early management. Others do not.
Pushing through worsening shin pain can increase the risk of:
longer recovery
recurring flare-ups
reduced running tolerance
altered gait and compensation
progression to more serious bone stress injury in some cases
If the pain is building rather than settling, it is better to get it assessed early.
Why patients in Albany Creek choose My Family Podiatry for shin pain
At My Family Podiatry, we regularly assess runners, athletes and active adults with shin pain. We focus on finding the actual reason the shin is overloaded rather than simply labelling it and telling you to rest.
Depending on the case, your assessment may involve:
gait analysis
footwear assessment
strength and symmetry testing
orthotic assessment where relevant
shockwave therapy planning where appropriate
guidance around training load and return to sport
We see patients from Albany Creek, Eatons Hill, Bridgeman Downs, Warner, Aspley, Carseldine and across North Brisbane for shin splints, running injuries and lower limb pain.
Frequently Asked Questions About Shin Splints
What are shin splints?
Shin splints is a broad term used to describe pain along the shin, often linked to medial tibial stress syndrome. It usually develops from repeated overload rather than a single traumatic injury.
How do I know if my shin pain is more serious than shin splints?
If the pain is very localised, severe, painful at rest, painful at night or not improving, it is important to consider a stress reaction or stress fracture. This is where professional assessment is important.
Should I stop running if I have shin splints?
Not always completely, but you usually need to modify training. In many cases, reducing impact load temporarily is more helpful than pushing through worsening pain.
Do shoes matter for shin splints?
Yes. Shoes that are worn out, unstable or not suited to your mechanics or training demands can contribute to shin overload.
Can orthotics help shin splints?
They can in the right person. If foot posture and force distribution are contributing to the problem, orthotics may help reduce ongoing stress through the shin.
Is stretching enough to fix shin splints?
Usually not. Stretching may help some people feel better, but long-term improvement usually requires better load management, strength work and addressing the reason the shin is overloaded.
Can shockwave therapy help shin splints?
In some stubborn soft tissue-related cases, shockwave therapy can be useful. It is not appropriate for every type of shin pain, especially where bone stress injury is suspected.
When should I see a podiatrist for shin splints?
If the pain keeps returning, is affecting your running or sport, or is becoming more intense, it is worth getting assessed before it becomes a longer-term issue.
Final thoughts
Shin splints can be frustrating because they often start small, then slowly interfere with more and more of your training. The good news is that with the right assessment and management plan, most cases improve well.
If shin pain is holding you back from training or everyday activity, early assessment can prevent long-term issues. Call My Family Podiatry on 07 3088 6116 or contact us to see our team in Albany Creek. We regularly help runners and active individuals from Bridgeman Downs, Aspley, Eatons Hill and across North Brisbane return to activity safely and confidently.