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Shin Splints

Shin splints are a training load error. The bone is reacting to what the programme demands.

Written by Alexander Khang, ISRM Level 5 Soft Tissue Therapist. 935 sessions delivered. 265+ five-star reviews.

What is Shin Splints?

Shin splints, medically known as medial tibial stress syndrome (MTSS), is periosteal irritation along the inner edge of the tibia. It is a stress response: the bone is being loaded faster than it can remodel. In early stages, pain eases with warm-up. As it progresses, pain persists through activity and eventually becomes constant.

Left unmanaged, it can progress to a tibial stress fracture, a more serious injury requiring full rest and investigation.

Shin Splints explained: Tibia and tibialis anterior, lower leg front | Achilles Clinic condition guide

Why it happens

Too much running volume, too soon. This is the most common cause. The tibial bone needs 8 to 12 weeks to fully remodel to a new training stress.

Novice runners, those returning after a break, and athletes crossing over from non-impact sports are the highest-risk group. Overpronation, weak hip abductors, and inadequate footwear all increase tibial loading per stride.

"The bone adapts to load over 8 to 12 weeks. A programme that demands adaptation in 2 weeks will produce injury."

How we treat Shin Splints

Assessment

We find exactly where the pain sits and rule out a stress fracture before anything else.

Tension Release

Hands-on soft tissue work through the lower leg, and further up the chain where the load starts.

Strength Rebuild

A gradual, planned return to running, with strength work so bone and muscle can keep up.

Relevant Clinical Articles

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Stress fracture vs shin splints: how to tell them apart

Medial tibial stress syndrome and tibial stress fracture produce similar symptoms but require completely different management. The clinical differentiation.

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