Shin Splints

Shin Splints

The term ‘shin splints’ is a general term used to describe pain experience at the front and/or inside of the shin bone (tibia). It is referred to medically as medial tibial stress syndrome and is often described by the phrase “too much, too soon”. They often begin after physical activity, especially when the intensity of activity has recently been increased or just started. Shin splints need to be differentiated from other conditions that often present with similar symptoms in the same region of the leg such as compartment syndrome, tibialis anterior tendonitis and a tibial stress fracture. 

What causes shin splints?

It is important to note that because there is no consensus on the definition of shin splints and it is used as a broad or general term, it is difficult to describe the exact cause. The thoughts around the mechanism of action includes:

• Micro-tears in the muscles attached to the front and/or side of the shin bone
• Inflammation of the tissue sheath around the shin bone (periosteum)
• Inflammation of a muscle coming away from the tibia

It has been noted that risk factors for shin splints include:

• High levels of physical activity
• Flat feet and pronation
• Poor (or worn out) footwear
• Largely favouring and overusing one foot over the other during physical activity
• Tight muscles
• Hormonal imbalances in females
• Type of surface on which activity is performed
• Decreased flexibility, especially in the calf muscles
• Low bone mineral density (Vitamin D or calcium deficiency)

What are the symptoms?

Symptoms of shin splints can include pain, tenderness, swelling and inflammation at the front and inside of the leg. Shin splints typically affect one leg, though both can be affected. The pain can be elicited on palpation of the shin bone and often occur after, or even during physical activity. Shin splints may feel worse in the morning, after muscles have tightened when resting overnight. Actions that use the anterior and medial muscles of the leg (front and inside), such as pointing your toes up, especially when the foot is resisted.  

Treatment for Shin Splints

Treatment focuses on reducing inflammation, correcting biomechanical issues, and gradually restoring function. Depending on the severity and underlying cause of your shin splints, your treatment may include:

• PRICE Protocol
  Protection, Rest, Ice, Compression and Elevation may be used initially to settle inflammation and reduce pain, especially in acute or recently aggravated cases.
  
• Orthotic Inserts
  Custom orthotics help correct faulty biomechanics, such as overpronation or flat feet, that may increase strain on the muscles and soft tissues attaching along the shin. Offloading stress from the tibia allows for faster healing and helps prevent recurrence.
  
• Stretching
  Tightness in the calf muscles and surrounding tissues can contribute to excessive traction and stress on the tibia. Gentle, progressive stretching of the calves and posterior chain is introduced once pain levels allow.
  
• Strengthening
  A tailored strengthening program will help improve lower limb stability, especially targeting the deep calf muscles (e.g., tibialis posterior) and other foot and ankle stabilisers. Strengthening also helps support long-term recovery and reduce re-injury risk.
  
• Footwear Assessment
  We’ll assess your current footwear to ensure it offers appropriate cushioning, arch support, and shock absorption. Old, worn-out shoes or inappropriate styles can significantly worsen symptoms or delay healing.
  
• Shockwave Therapy
  Shockwave delivers acoustic pulses into the affected area, promoting healing, increasing blood flow, and reducing chronic inflammation. It’s particularly effective when symptoms persist despite conventional care.
  
• Laser Therapy
  Our advanced Class IV medical laser therapy reduces inflammation, improves local circulation, and accelerates tissue healing at a cellular level — ideal for stubborn or long-standing shin pain.
  
• Acupuncture or Dry Needling
  These techniques target deep muscle tightness, especially in the calves and shin region. Releasing trigger points and improving blood flow can significantly reduce pain and restore normal function.
  
• Activity Modification & Load Management
  We’ll provide specific guidance on modifying your training load, running technique, or daily activities to reduce further strain on your shins while you recover — without requiring complete rest in most cases.