Shin splints explained: How to identify and manage this running injury

Get back to running with these top tips
Shake off shin splints for good

One of the most common running injuries that can occur are shin splints. Although the pain usually isn’t completely overwhelming when you have shin splints, it’s certainly enough to ruin a run, and the injury can sideline you for a long period if you let it go untreated.

To help ensure that doesn’t happen to you, we enlisted a trio of experts – Professor Edward R. Laskowski (M.D.), co-director, Mayo Clinic Sports Medicine, Emily B. Beyer, instructor in physical therapy, Mayo Clinic College of Medicine and Jeff Strauss, physical therapist at the Mayo Clinic – or their advice on how to spot, prevent and treat shin splints.

What are shin splints?

Shin splints explained: How to identify and manage this running injury

“The term 'shin splints', or medial tibial stress syndrome, refers to pain along the shin bone or tibia - the large bone in the front of your lower leg,” says Beyer.

For all its many downsides, shin splints is at least a relatively easy injury to spot. The pain in your shins will usually get worse as you run, turning from a dull ache into something much sharper, and if the injury gets more severe you will experience in when resting as well.

What causes shin splints?

“Shin splints often result from training errors, which usually involve the 'Terrible Toos' – too long a distance, too rapid a progression in intensity, and too rapid a progression in distance can all result in more loading than the bone and muscle in the region can handle,” says Laskowski.

This is why shin splints often occur in new runners who have suddenly started running three times a week, or in experienced runners who ramp up their training too quickly at the start of their training plan for an event like a marathon. Running is a high-impact activity, especially when done on hard surfaces like asphalt, and that extra impact on a body that’s not used to it can lead to injury.

However, the Terrible Toos are not the only cause of shin splints. If you’ve neglected your strength training or have a quirk in your running technique, that can also lead to the problem.

“There also may be anatomic issues which may contribute,” says Laskowski. “Poor control of the lower leg and knee during running, which often contributes to the knee going inward when the foot strikes the ground, can increase loading of the lower leg.”

How do you prevent shin splints?

Shin splints explained: How to identify and manage this running injury

The best preventative measure you can take is increase your training load carefully.

“A gradual progression in mileage and intensity is important,” says Laskowski. “Usually no more than a 10% increase in mileage per week is recommended.”

If you’re starting from scratch, take rest days between your runs and limit your distance to around 5K at first – you’ll probably welcome stopping at that point any way. Once you’re into your running, be careful in increasing both distance and intensity – you should be doing a mix of easy and hard runs, and it’s key not to overdo the quick stuff, which can cause shin splints to crop up.

If you’re training smart but still suffering with shin splints, then you might need to look into your running technique and your cross training routine to see if that’s where the problem lies.

“A heel strike pattern of landing first on the heel rather than the middle of the foot can also increase lower leg forces,” says Laskowski. "Exercises to strengthen the core and hip group muscles can help to improve movement patterns in the lower leg and distribute forces more evenly.”

Runners have an unfortunate tendency to neglect their strength and conditioning, but working on your core and lower body muscles will not only reduce your risk of injury, it will also make you a better runner as well.

“A slight increase in cadence, which is the rate at which your steps turn over during running, can help to make you more of a midfoot striker and can distribute lower leg loading force better,” says Laskowski. "As little as a 10% increase in your cadence can make a difference.”

Many running watches and fitness trackers will track your cadence during a run, but you can also check your cadence yourself by counting your steps while running. To make it easier, just count each time one foot strikes the ground for 30 seconds, then multiply that by four for your overall cadence over a minute.

Another way to reduce your risk of shin splints is to head for softer ground.

“Running on trails and alternate surfaces is definitely a way to reduce stress and shock on your bones,” says Strauss.

Logging every run on the road puts a lot of strain on the body, especially if you’re a beginner unused to that strain. Even if you don’t have unlimited access to untamed wilderness, heading for a city park and finding a trail in there can reduce the load you place on the body when running.

How do you treat shin splints?

Shin splints explained: How to identify and manage this running injury

The first step to take when shins splints strike is to stop running and get your feet up. Resting the area is vital, and you can also ice it for 10 to 20 minutes at a time several times a day. If you want to reduce the pain use over-the-counter options like ibuprofen and paracetamol.

If your shin splints are causing you severe pain, don’t go away after a couple of weeks of rest, or reoccur every time you try and start running again, then it’s time to visit a physio for both immediate treatment and an analysis of your running to see what might be causing the injury.

“Shin splints are treated in a variety of ways,” says Strauss. “First, a reduction of running or impact is needed, so cutting back on activity is a starting point. In extreme situations, crutches or a walking boot will help to dissipate forces.

“In more mild cases, improving lower extremity strength and flexibility is important while a person is not running, so when they return to their sport, their muscles can help offload their shin splints.

“Lastly, a running analysis can help to evaluate possible running patterns that can be problematic and lead to shin splints.”

How long can it take for shin splints to heal?

Shin splints explained: How to identify and manage this running injury

“Shin splints can take weeks or longer to heal,” says Strauss. “However, proper rest and therapy can help decrease the pain you feel with more immediate effect.”

This is definitely not an injury you want to try and run through, because it will just prolong and exacerbate the pain and potentially lead to you being unable to run for months. Rest up at the first sign of shin splints and you should be back on your feet in a couple of weeks.

If you still want to be active during this period, opt for low-impact actives like swimming or the elliptical to ensure you’re not stressing your shins. Then, when you do start running again, it’s vital to gradually increase the amount you do, and spend as much time as you can on softer ground rather than pounding the pavements.


Are there any products that can help prevent or treat shin splints?

There’s no magic bit of kit that will stop you getting shin splints, but you can certainly reduce your risk by getting the right running shoes.

“While there is no treatment that guarantees resolution of symptoms, appropriate footwear can help dissipate forces that can lead to shin splints,” says Strauss.

The large stack cushioning on most running shoes is designed to reduce the impact of the sport, which is why it’s worth getting a dedicated pair of running kicks. Try and test a few pairs out on a treadmill before buying, and there’s no harm in getting the free gait analysis offered in most running shops, although this is no substitute for proper technique analysis by a physio if you are getting regular injuries.

Physios might also prescribe customised insoles to put in your running shoes help with the condition. You can also find insoles that mould to your foot in chemists and running shops, which are far less sophisticated and so cheaper than the orthotics you get from a physio. While these might help, going to a physio will help you identify the root cause of a regular injury and hopefully lead to a plan to fix it, whether that’s through a custom insole or exercises to strengthen the lower body.

Some runners also use compression socks and calf sleeves to help manage shin splints. The idea behind this is it reduces the vibrations in your lower leg while running. This treatment isn’t well-established or backed up by evidence at the moment, but compression gear is reasonably cheap and isn’t going to hurt you, so there’s little harm in trying it out if you think it might help.

Tags:   Running
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