Shin Splints
Shin splints are one of the most common complaints among runners and anyone who’s recently ramped up their training, and while they’re rarely serious on their own, ignoring them can let the problem progress into something more significant.
At Emerald Hill Podiatry, we look beyond just resting the pain away, identifying the mechanical factors behind the overload so the same ache doesn’t return the moment training resumes.
What Are Shin Splints
Shin splints, medically known as medial tibial stress syndrome, describe pain along the shin bone (tibia) caused by inflammation of the muscles, tendons, and tissue surrounding it. The pain is typically felt along the inner edge of the lower leg and develops from repeated stress on the shin bone and surrounding structures. It’s a very common overuse injury, and while most cases resolve with appropriate rest and treatment, shin splints that are ignored can progress into a tibial stress fracture.
What Causes Shin Splints
Shin splints develop when the muscles and connective tissues around the shin repeatedly pull on the bone faster than it can recover, most often triggered by:
- A sudden increase in running distance, intensity, or frequency
- Starting a new sport or exercise routine without adequate conditioning
- Running on hard, uneven, or hilly surfaces
- Worn-out or unsupportive footwear
- High-impact or repetitive activities such as running, jumping, dancing, or marching
Splints vs Fracture
Because both conditions cause pain along the shin bone and both stem from overuse, shin splints and a stress fracture can be difficult to tell apart without a professional assessment.
Shin splints tend to cause pain spread diffusely along a length of the shin bone, while a stress fracture is usually more sharply localised to a single, specific point. Shin splint pain often eases somewhat with rest between sessions, while stress fracture pain tends to persist even after activity stops and may worsen with continued loading.
Because a stress fracture doesn’t always show up on an X-ray in its early stages, further imaging such as an MRI may be needed if a fracture is suspected.
Biomechanical Factors in the Overload
Certain foot types and movement patterns place extra strain on the shin, including flat feet, high or rigid arches, and a foot that rolls excessively inward when walking or running (overpronation).
These conditions change how impact force travels up the leg, concentrating stress on the tibia rather than distributing it evenly. Runners transitioning to new terrain, worn shoes that no longer offer adequate support, and a sudden jump in training volume all compound the effect.
Identifying which of these factors is at play is central to preventing shin splints from becoming a recurring problem.
When to See a Podiatrist
See a podiatrist if:
Shin pain doesn't improve after a few weeks of rest and reduced activity
The pain has become constant, rather than only appearing during exercise
You suspect the pain may be a stress fracture rather than simple shin splints
Shin splints keep recurring each time you return to training
You're unsure whether your footwear or running mechanics are contributing to the problem
Get Your Shin Splints Properly Assessed
Our Approach
In the early stages, relief starts with the basics: resting from the aggravating activity, icing the shin for 10 to 20 minutes several times a day, and easing back into training gradually rather than jumping straight back to your previous mileage or intensity. But for shin splints that keep coming back, symptom relief alone isn’t enough, we look at what’s driving the overload in the first place.
Treatment options include:
- Biomechanical Gait Assessment — identifies overpronation, arch type, or gait patterns placing excess strain on the shin
- Custom Orthotics — support the arch and correct alignment issues that concentrate stress on the tibia, particularly for flat feet, high arches, or rigid arch types
- Strengthening and Stretching Program — targeted exercises to build lower leg strength and flexibility, easing the pull of the muscles on the shin bone
- Shockwave Therapy (ESWT) — supports healing in persistent or slow-resolving cases where rest alone hasn't fully resolved the pain
- Footwear Guidance — advice on supportive running shoes suited to your foot type and training surface, replaced regularly as worn-out shoes lose their supportive structure
What to Expect at Your Assessment
Your podiatrist reviews your training history and footwear, examines your gait, and checks for tenderness along the shin to help distinguish shin splints from a possible stress fracture. Imaging may be arranged if a fracture is suspected. From there, a plan is set to manage symptoms in the short term and correct the mechanical cause so shin splints don’t become a recurring part of your training.
