top of page

Shin Splints: Causes, Management, and Prevention

  • Writer: integratedsands
    integratedsands
  • Aug 21
  • 3 min read

Written By Felix Adamson-Walter, Osteopath & Injury Rehab Coach


Shin splints, also known as Medial Tibial Stress Syndrome (MTSS), are a common overuse injury experienced by runners, walkers, and athletes in sports with repetitive impact. They present as a dull, aching pain along the inner edge of the shinbone (tibia), often worsening with activity and easing with rest.



Runner running on the road

Causes of Shin Splints


MTSS usually develops when the muscles, tendons, and bone tissue around the tibia are

overstressed.


Common contributing factors include:


  • Sudden increases in training volume or intensity


  • Running on hard or uneven surfaces


  • Wearing worn-out or unsupportive shoes


  • Poor foot mechanics such as uncontrolled or lack

    of pronation


  • Weakness in the lower leg and foot muscles









Management Strategies

Osteopath Felix working on strength

Effective management of MTSS focuses on reducing load, addressing contributing factors,

and restoring normal function:


1. Relative Rest: Reduce or modify high-impact activities, swapping to low-impact alternatives like swimming or cycling whilst the pain reduces.


2. Footwear Check: Ensure shoes provide adequate cushioning and support, a running or walking gait assessment can help find the right footwear for you.


3. Strengthening Exercises: Focus on calf raises, foot stability, and plyometrics to improve load tolerance.


4. Mobility Work: Stretching and foam rolling the calves and tibialis anterior, whilst working on specific foot and ankle mobility drills for your needs.


5. Holistic wellbeing: Sometimes the basics are overlooked. You are going to struggle to recover from intense training if you are not eating, sleeping, and hydrating well.




Osteopath Felix exercising at the gym

Prevention Tips


To reduce your risk of MTSS and keep your lower legs healthy:


  • Increase training volume gradually, following the 10% rule.


  • Incorporate strength and mobility work into your weekly routine.


  • Vary training surfaces where possible.


  • Replace running shoes regularly (every 500+ km).


  • Listen to your body and address early signs of pain before they worsen.













The Stress Fracture Link


While shin splints are considered a soft tissue and periosteal (bone covering) irritation, they can be a warning sign of something more serious. If the repetitive stress continues without adequate rest and recovery, MTSS can progress into a tibial stress fracture. This is a small crack in the bone that requires significant rest, sometimes 6-8 weeks or more, while severe cases may need immobilisation. Recognising and addressing shin splints early is key to preventing this escalation.



Key Takeaway


Shin splints can be frustrating, but with early management and the right approach, you can recover fully and prevent recurrence. Ignoring symptoms risks progression to a tibial stress fracture, which means a much longer time away from sport. Act early, adjust your training, and build strength to keep your legs strong and resilient.


If you need some extra support, book an appointment with Felix, here.



Osteopath Felix treating in clinic


References:


  1. Winkelmann, Z. K., Anderson, D., Games, K. E., & Eberman, L. E. (2016). Risk factors for medial tibial stress syndrome in active individuals: An evidence-based review. Journal of Athletic Training, 51(12), 1049–1052. https://doi.org/10.4085/1062-6050-51.12.13 PubMed

  2. Reinking, M. F., Austin, T. M., Richter, R. R., & Krieger, M. M. (2017). Medial tibial stress syndrome in active individuals: A systematic review and meta-analysis of risk factors. Sports Health, 9(3), 252–261. https://doi.org/10.1177/1941738116673299 NCBI

  3. Gomez-Garcia, S., Rona, S. R., Tinoco, M. C. G., Benet, R. M., Chaustre, D. M., Cardenas, F. P., Lopez-Illescas, Á., & Alarcon, J. M. G. (2017). Shockwave treatment for medial tibial stress syndrome in military cadets: A single-blind randomized controlled trial. International Journal of Surgery, 46, 102–109. https://doi.org/10.1016/j.ijsu.2017.08.584 PubMed

  4. Ogata, A. (2019). The risk factors of medial tibial stress syndrome in Division II track-and-field and cross-country athletes (Master’s thesis). Texas A&M University–Commerce. https://digitalcommons.tamuc.edu/etd/378 digitalcommons.tamuc.edu

  5. Winters, M., Eskes, M., Weir, A., Moen, M. H., Backx, F. J., & Bakker, E. W. (2020). The diagnosis and management of medial tibial stress syndrome: An evidence update. Unfallchirurg, 123(Suppl 1), 15–19. https://doi.org/10.1007/s00113-019-0667-z NCBI

Comments

bottom of page