MSK Rehabilitation, Patient Guide

Shin splints: causes, what helps and when it might be something else

Written by Elliot Stubbs, BSc (Hons) Physiotherapy, 13 years in MSK practice. Updated 14 October 2026.

Shin splints are an aching pain along the inner edge of the shin bone, usually brought on by running or jumping, and most often after a sudden increase in training. It usually settles with reduced running and steady calf and foot strength work rather than complete rest. Sharp pain on one spot of bone, or pain at rest or at night, is different and worth getting checked.

What are shin splints?

The medical name is medial tibial stress syndrome: stress-related pain along the inner ("medial") edge of the shin bone (the tibia), usually over its lower half.

It's thought to be the bone, and the tissue attached to it, reacting to more repeated impact than it's currently ready for. Bone strengthens with load, but needs time. When training climbs faster than that, the shin gets sore. It isn't a break.

What causes shin splints?

Usually a mix of:

A sudden jump in training. More, longer or faster running added in a short space of time. The most common pattern, often in newer runners or those training for a first race.
A change of surface. More road running, or hard or sloping surfaces, can increase load through the shin.
Calf and foot strength that hasn't kept up. The calf and foot muscles absorb impact with every stride. If they tire quickly, more load passes into the shin.
Footwear changes. Very worn shoes, or a sudden switch to a very different shoe, can contribute. Comfortable shoes that suit you are sensible, but rarely the whole story.

What do shin splints feel like?

Typically:

A dull ache along the inner shin, spread over several centimetres
Tenderness when you press along the bone's edge
Pain early in a run that may ease as you warm up, then returns afterwards
Sometimes both legs at once

If nothing changes, it tends to come on earlier in runs and linger longer afterwards.

Is it shin splints or a stress fracture?

This is the most important question. A bone stress injury (a stress reaction, or a stress fracture, which is a small crack in the bone from repeated load) can start similarly but needs more careful management. Signs that point that way include:

Sharp tenderness on one small spot of bone that you can point to with a fingertip
Pain that hangs around at rest, or wakes you at night
Pain when hopping on the affected leg
Pain with walking that is getting worse rather than better

If any sound familiar, stop running and get assessed by a physio or your GP; a scan is sometimes needed. Mention it if you've had stress fractures before, your periods have become irregular or stopped, or you may not be eating enough for your training, as these can affect bone health and are worth discussing with your GP.

Could it be compartment syndrome?

Less commonly, leg pain comes from pressure building up inside the lower leg muscles during exercise (chronic exertional compartment syndrome). It feels different:

A tight, full or burning feeling in the muscles rather than an ache on the bone
Coming on at a predictable point in a run, easing within minutes of stopping
Sometimes numbness or tingling in the foot, or the foot feeling weak

If that sounds like you, see your GP rather than running through it.

Simple self-checks you can do safely

These won't diagnose you. Stop if anything causes sharp pain.

The finger test. Press gently along the inner edge of your shin. Is the tenderness spread out, or on one small spot?
The rest check. Does the pain settle at rest, or ache at rest and at night?
A gentle hop. Only if walking is comfortable, try a few small hops on the affected leg. If that hurts on the bone, don't repeat it; get assessed.
The next-day check. How does your shin feel the morning after a run?

What can I do about shin splints now?

Without the warning signs above, you usually don't need to stop everything, just reduce load enough for the shin to settle.

Cut back, don't necessarily stop. Reduce how often, how far and how fast you run. Some people need a short break from running.
Use a simple pain guide. Mild discomfort that settles soon after a run and isn't worse next morning is generally fine. Pain that builds, makes you limp or lingers means you've done too much.
Choose kinder routes. Flat, even ground and softer surfaces such as grass, for a while.
Keep fit in other ways. Cycling, swimming or a cross-trainer, with far less impact.
Start calf and foot strength work. Double-leg heel raises, done slowly, are a reasonable start if they don't increase your pain.

How does physiotherapy help shin splints?

An assessment checks for signs of a bone stress injury or compartment syndrome and finds what's driving your case: training load, strength, how you run, or a mix. Treatment usually involves:

Load management. What running, if any, you can do now, and how to build back up.
Progressive calf and foot strength. The backbone of treatment: heel raises progressing to single-leg and weighted versions in the gym, plus shin and foot muscle work.
Running technique. For some, a slightly shorter, quicker stride reduces impact through the shin.
Manual therapy. Hands-on calf work for short-term relief, alongside exercise, not instead of it.
A graded return. Hopping and skipping before running, then distance, pace and harder surfaces back one at a time.

Sessions here take place in a fully equipped gym with 1:1 guided rehab. Our guide to returning to running after injury covers the return-to-run stage, and if your knees are complaining too, see the runner's knee guide.

How long do shin splints take to heal?

It varies. Milder cases often settle within a few weeks of adjusting training; a full return to normal running commonly takes a couple of months or more. Bone stress injuries usually take longer. Shin splints can return if training jumps again, so keeping up calf strength work afterwards is worthwhile.

When to see a GP or get urgent help

Get urgent medical help (call 111, or go to A&E) if: you have severe lower leg pain after an injury or a fall, especially if the leg looks swollen or deformed or you can't put weight on it; your lower leg feels very tight with pain that's getting worse despite rest and pain relief; or your shin is hot, red and swollen and you feel unwell or have a temperature. Call 999 if you have calf pain or swelling alongside chest pain or breathlessness.

See your GP if you have pinpoint bone pain, pain at rest or at night, or pain with hopping; tightness, numbness or tingling during exercise that eases when you stop; or shin pain with unexplained weight loss or feeling generally unwell. In the uncommon cases where it's relevant, a GP or specialist can discuss other options such as surgery.

Physio for runners in Wymondham and Norwich

If you're in Wymondham, Norwich or South Norfolk, Elliot sees runners at Suggs Gym on Tuesday evenings. No GP referral is needed, and you can see the assessment and follow-up prices before you book an assessment.

Frequently asked questions

Can I keep running with shin splints?

Often, yes, if you run less, on flatter and softer routes, and any discomfort is mild and gone by the next morning. If pain builds, makes you limp, or becomes sharp on one spot of bone, stop and get assessed.

How can I tell shin splints from a stress fracture?

Shin splints usually cause spread-out tenderness along the inner shin that eases with rest. Pinpoint bone pain, pain at rest or at night, or pain when hopping can point to a bone stress injury, which needs assessing and sometimes a scan.

Do I need new running shoes for shin splints?

Not necessarily. Replace very worn shoes with a comfortable pair, but shoes alone rarely fix shin splints. How quickly you've increased your training usually matters more.

Should I ice shin splints?

Ice can ease soreness in the short term and is fine if it helps, but it won't build strength, so use it alongside adjusted training and strength work.

Do I need a GP referral to see a physio for shin splints?

No. You can book a physiotherapy assessment directly without seeing your GP first. See the guide on self-referral for physiotherapy for more detail.

This guide is general information written by a physiotherapist, not a substitute for individual assessment. If you're unsure about any of the warning signs above, seek medical advice rather than waiting for an appointment.