Shin splints (medial tibial stress syndrome)
Why do my shins hurt when I run?
Exercise-related pain along the inner edge of the shin bone, common in runners and in people increasing their training.
What it feels like
Pain along the inner edge of the shin bone, over a stretch of at least several centimetres, brought on by running or jumping. It is often worst at the start of a run and may ease as you warm up, then ache afterwards.
What is actually happening
Medial tibial stress syndrome is thought to be a stress response of the bone and its lining along the shin, related to loading that has increased faster than the bone and surrounding tissues have adapted. It is different from a bone stress injury, where pain is focused on one small spot, and from exertional compartment syndrome, where tightness, aching or numbness builds during exercise and settles with rest.
When to see a doctor
See your doctor if the pain is on one specific spot of the bone, hurts at rest or at night, or if you have numbness, weakness or foot changes during exercise.
How it is assessed
Assessment includes the location and pattern of the pain, tenderness along the shin, hopping tests, your training history, footwear and running mechanics, and screens for a bone stress injury.
How it is treated
A systematic review of treatments for medial tibial stress syndrome found no single treatment clearly better than others, so management focuses on adjusting running load, a graded return-to-running programme, strengthening of the calf and lower limb, and addressing training errors. Shockwave therapy may be considered for persistent symptoms, though the evidence is limited.
What to do first
Reduce running volume and intensity, avoid hard surfaces and sudden increases for now, maintain fitness with cycling or swimming, and have it assessed if it is not settling or if one spot is very tender.
Where this is assessed
- The Runner's Academy St. Clair West · Mon/Wed/Fri · 3:00 PM – 6:30 PM Book at Runner's Academy
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
References
This page is based on the following clinical practice guidelines and research.