Shin splints (medial tibial stress syndrome)

Conditions
Written by Chris Greenslade

Shin splints, or medial tibial stress syndrome, is pain along the inner edge of the shin bone that comes on with exercise such as running or jumping. It happens when the leg is loaded more than it is ready for. Most people improve within weeks with load changes and a gradual return to activity.

Also known as shin splints, medial tibial stress syndrome, MTSS, load-induced medial leg pain

How commonShin splints is one of the most common sports injuries. Around 1 in 5 running and jumping athletes are thought to develop it at some point, and it is also common in military recruits.3

Symptoms

  • Dull ache or tenderness along the inner edge of the shin bone
  • Pain that starts during or after exercise, especially running
  • Tenderness spread over several centimetres rather than one spot
  • Pain that eases with rest early on but can linger as it progresses
  • Often affects both legs

Causes and risk factors

  • Increasing running or training too quickly
  • Returning to exercise after a period of inactivity
  • Running or jumping on hard surfaces
  • Higher body mass index (BMI)
  • Foot and hip factors, such as a larger drop of the arch when standing
  • A previous episode of shin splints

What the evidence says helps

  • Reducing the activity that causes pain, then rebuilding gradually, is recommended in NHS guidance. Gentle exercise such as swimming can keep you fit while it settles.1
  • Many treatments have been tested, but research quality is low. No single treatment has been shown to be clearly better than others.26
  • Expert opinion supports load management, gradual exposure to running and strengthening the calf muscles as a sensible approach.3
  • Shockwave therapy and arch-support insoles have shown some short-term benefit in small studies, but the evidence is limited.26
  • For prevention, evidence suggests neuromuscular training programmes and supportive insoles may lower the risk of shin splints. Shock-absorbing insoles and stretching do not appear to help.5
  • Risk factors linked to shin splints include higher BMI, a larger arch drop and differences in hip and ankle movement, which can guide assessment.4

Things you can try at home

  • Cut back or pause the activity that triggers your pain, and swap to low-impact exercise for a while
  • Use an ice pack wrapped in a towel for up to 20 minutes to ease soreness
  • Build back up slowly, increasing distance before speed
  • Run on softer surfaces where you can, and wear supportive trainers
  • Add simple calf-raise exercises as pain allows

When to get urgent help

Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:

  • Severe pain, or pain after a fall or knock to the shin: contact NHS 111
  • Pain in one small spot on the bone that hurts at rest or at night: see your GP, as this may be a stress fracture
  • Numbness, pins and needles or weakness in the foot during exercise: see your GP
  • A hot, red, swollen calf with throbbing pain: get an urgent GP appointment or call NHS 111
  • Calf swelling with chest pain or breathlessness: call 999

How Apollo can help

We start with a thorough assessment to check the pain fits shin splints and to rule out a stress fracture or other causes. We explain what is going on and agree a plan to adjust your training load. Your rehab may include calf and hip strengthening, gait and running assessment, and a graded return-to-running plan. If we suspect a bone injury, we will refer you for imaging or to your GP.

Sports therapy Biomechanics assessment Osteopathy Clinical exercise
Poppy WilliamsSports TherapistChris GreensladePrincipal Osteopath
Book an appointmentCall 01603 736238

No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.

Related reading

Frequently asked questions

How long do shin splints take to heal?

Many people improve within a few weeks once they reduce the activity causing pain. Getting back to full running can take longer, especially if symptoms have been present for months. A gradual return lowers the chance of it coming back.

Can I keep running with shin splints?

It is usually best to cut back or pause running while the pain settles. Low-impact exercise like swimming or cycling can keep you fit. When you return, build up slowly and stop if pain increases.

How do I know if it is shin splints or a stress fracture?

Shin splints usually cause tenderness spread along the inner shin. A stress fracture tends to hurt in one small spot and may ache at rest or at night. If you are unsure, get it checked, as a stress fracture may need imaging.

References

  1. NHS. Shin splints. NHS website (accessed November 2026). View source
  2. Winters M, et al. (2013). Treatment of medial tibial stress syndrome: a systematic review. Sports Medicine. View source
  3. Winters M (2017). Medial tibial stress syndrome: diagnosis, treatment and outcome assessment (PhD Academy Award). British Journal of Sports Medicine. View source
  4. Hamstra-Wright KL, et al. (2014). Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. British Journal of Sports Medicine. View source
  5. Marques T, et al. (2025). Preventive interventions for medial tibial stress syndrome: systematic review and meta-analysis. Gait & Posture. View source
  6. Teles AI, et al. (2026). Load-induced medial leg pain in runners: a systematic review of non-invasive treatment approaches. Physical Therapy in Sport. View source

This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.

Chris Greenslade
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