Shin splints in runners have a special talent for showing up right when running is finally feeling good again.
Maybe you’ve been building for a race, or returning after time off. Then a familiar ache starts creeping along the inside of your shin.
It’s frustrating, especially when you’re trying to be consistent with your running. The good news is that shin splints usually aren’t random. They often show up when your current running load is higher than what your lower leg can comfortably tolerate. So with a bit of investigating, we can often pinpoint what may be the cause.
So what are “shin splints”? Shin splints is the common term runners use for pain along the shin bone, clinically referred to as medial tibial stress syndrome, or MTSS. It’s usually linked to repetitive loading that your lower leg isn’t currently tolerating well, rather than one single “bad” run, or bad shoe. MTSS is common in runners, and it’s often described as exercise-related pain along the medial border of the tibia.
The good news? You don’t need to panic-buy new shoes or quit running forever. You need to check the biggest possible causes: training load, footwear changes, lower leg strength, running mechanics, and recovery.
First, Is It Really Shin Splints?
Shin splints often feel like a dull, achy, or tender pain along a broader area of the inner shin. Early on, shin splints may feel worse at the start of a run, ease as you warm up, then return later in the run or afterward. Even if the pain settles during the run, it’s still a sign that your lower leg is not tolerating your current training load well.
A tibial bone stress injury, including a stress reaction or stress fracture, can look similar at first. Get assessed if your pain is sharp, very focal, worsening from run to run, present with walking, painful at rest or at night, associated with swelling, or if you can’t hop on the leg without significant pain. Bone stress injuries often need a multifactorial approach to diagnosis, management, and return to sport, and high-risk locations need medical attention.
Quick Symptom Check
| Check | More likely manageable shin irritation | Needs assessment sooner |
|---|---|---|
| Pain location | Diffuse ache along inner shin | One very specific tender spot |
| During running | Improves as you warm up or stays mild | Gets worse as you continue |
| After running | Settles within 24 hours | Lingers or worsens the next day |
| Daily life | Walking is comfortable | Pain with walking, stairs, or rest |
| Hop test | Very mild or no pain | Sharp or significant pain |
This table is not a diagnosis, but it can help you decide whether your symptoms are manageable with training adjustments or need a medical assessment.
The Shin Splints Checklist for Runners
When shin pain pops up, start with this checklist.
1. Load: Did Anything Change Recently?
Look back over the last two to six weeks. Did you:
- Increase weekly mileage?
- Add new speedwork, hills, stairs, track sessions, or tempo runs?
- Extend your long run?
- Return after illness, travel, vacation, or a busy work stretch?
- Change surfaces, such as moving from treadmill to pavement?
- Start running more days per week?
- Add new strength training, sports, hiking, or long walks?
A large cohort study of 5,205 runners found a higher rate of overuse injury when one run was at least 10% longer than the runner’s longest run in the previous 30 days. For shin splints, the practical takeaway is to check for sudden single-run spikes, not just changes in weekly mileage.
2. Footwear: Did Your Shoes Change the Load?
Shoes don’t “fix” shin splints by themselves, but they can change where load goes. A sudden move to a lower-drop, lighter, more flexible, or more minimalist shoe can increase demand on the foot, ankle, calf, and Achilles. A higher drop shoe can increase demand at the hip, knees, and lower back. And a very high-stack shoe may feel cushy but could feel less stable for some runners, especially on cambered roads or trails.
The best shoe is the one that feels comfortable while running, matches your current capacity, and doesn’t create new symptoms. The evidence does not support one perfect shoe type for preventing running injuries across all adults, and prescribing shoes based only on static foot posture probably makes little or no difference to injury rates.
For more on this, check out Do Cushioned Running Shoes Really Prevent Injuries? and What’s the best running shoe?
3. Strength: Can Your Lower Leg Handle the Work?
Running asks a lot from the whole kinetic chain, especially the lower leg. Your foot, ankle, knee, hip, and trunk all help absorb and control repetitive impact, but your cardiovascular fitness can improve faster than your tissues adapt. This is especially true when returning from injury. You may have maintained fitness with cycling, elliptical, swimming, or other cross-training, while your shin, calf, or foot hasn’t been exposed to much running load. That can leave you feeling ready to run farther or faster before your bones, tendons, and lower-leg muscles are prepared for that change.
A 2025 randomized controlled study found that adding lower-leg exercises to a multimodal MTSS treatment plan improved foot posture measures and quality of life, although it did not significantly reduce pain or MTSS severity compared with the control group. That’s a useful reminder that strengthening is important, but it needs to be part of a broader plan.
4. Running Mechanics: Are You Overstriding or Landing Heavy?
You don’t need to chase a specific cadence or force a forefoot strike. Cadence and foot strike can influence load, but there is no universal number or landing pattern that works for every runner.
That said, a small cadence increase can sometimes reduce step length and shift loading, particularly if your current cadence is around or below 155 steps per minute.
A practical guideline is to try increasing cadence by 5% more steps per minute while keeping your effort relaxed. Think “shorter, quieter steps.” Cadence is often easier to work on whilst on whilst running on a treadmill where the pace and terrain can be easily controlled.
What to Do When Shin Splints Show Up
Step 1: Calm the Load Down
You don’t always need complete rest, but you do need to reduce the irritant.
For the next one to two weeks, consider:
- Pausing speedwork, hills, and hard downhill running.
- Keeping runs flat and easy.
- Reducing long run distance.
- Avoiding back-to-back running days.
- Using cycling, swimming, elliptical, or walking if they’re pain-free.
- Stopping a run if pain worsens, changes your gait, or doesn’t settle.
And most importantly, consider checking in with your physiotherapist if symptoms are persisting, worsening, changing how you run, or not settling with simple training adjustments.
A simple rule: symptoms should stay mild during the run and settle back to baseline by the next day. If they don’t, the load is too high right now.
Step 2: Check Your Shoes
Ask:
- Are these shoes new?
- Did the heel drop, stack height, stiffness, or support level change?
- Are they worn down?
- Are you using one shoe for every surface and workout?
- Do symptoms change when you rotate shoes?
Avoid making a drastic shoe change while your shin is already irritated. If you suspect your shoe is part of the issue, change one variable at a time and give your body time to adapt. For example, don’t switch to a lower-drop shoe in the same week you add hill repeats and increase your long run.
Step 3: Build Lower Leg Strength Progressively
Start with two to three sessions per week. Keep symptoms at a tolerable level, roughly 0 to 3 out of 10, and make sure they settle by the next day. Progress gradually.
Exercise 1: Standing Calf Raises
Use a wall or rack for balance if needed. Rise up slowly onto the balls of your feet, pause at the top, lower with control, and work toward single-leg strength over time. You can progress calf raises by adding load, slowing the lowering phase, increasing range of motion, moving to single leg, or building total volume gradually.
Exercise 2: Tibialis Posterior Calf Raises
Place a lacrosse ball between your heels. Gently squeeze the ball as you rise up into a calf raise, keeping pressure through the big toe and second toe. Lower slowly with control.
This variation helps bias the tibialis posterior, one of the muscles involved in supporting the arch and controlling the inside of the lower leg during running.
Progress by adding load, slowing the lowering phase, increasing range of motion, or adding more total volume over time.
Exercise 3: Tibialis Anterior Raises
Stand with your back against a wall and feet slightly forward. Keep your heels down and lift your toes toward your shins. Lower slowly.
This targets the front of the lower leg and can help build capacity for foot clearance and impact control.
Exercise 4: Single-Leg Strength and Control
Add exercises like step-downs, split squats, single-leg Romanian deadlifts, and lateral hip work. Shin splints are local, but the solution is rarely only local. Your lower leg does a lot more work when the hip, knee, and foot aren’t sharing the load well.
When to Get a Running Assessment
If shin pain keeps returning despite reducing load and building strength, a running assessment may help identify what’s contributing to the problem.
A proper running assessment should look at your training history, symptoms, shoes, running mechanics, strength, mobility, and goals. A running assessment can help identify whether your shin pain is more related to load progression, footwear changes, cadence, calf capacity, foot control, hip strength, or a combination of factors.
You can book your running assessment in Port Moody, BC HERE.
The Bottom Line on Shin Splints in Runners
Shin splints usually reflect a mismatch between current training load and tissue capacity. A good plan adjusts running volume, intensity, terrain, footwear, recovery, and strength work so your lower leg can adapt gradually.
Start by adjusting load, reviewing recent footwear changes, progressing lower-leg strength, and looking at running mechanics when needed. If the same shin pain keeps returning, get assessed early so you can address the contributing factors before it becomes a longer setback.
Key Takeaways
- Shin splints, often called medial tibial stress syndrome, are common in runners and usually relate to repetitive load.
- Big changes in long run distance, speedwork, hills, surfaces, or training frequency can irritate the shin.
- Shoes can change load, but there’s no single best running shoe for preventing shin splints.
- Lower-leg strength should include calf raises, tibialis posterior work, tibialis anterior raises, and single-leg control.
- Small cadence changes may help some runners.
- Sharp, focal, worsening, or pain at rest should be assessed to rule out bone stress injury.
Struggling With Shin Splints?
Explore online strength programs for runners, designed to build the strength and capacity your running needs. If you’re local to the Vancouver area and want a clearer picture of your running form, strength, footwear, and training load, book a Running Assessment.
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Frequently Asked Questions About Shin Splints in Runners
Shin splints are usually caused by a mismatch between running load and tissue capacity. Common triggers include increasing mileage too quickly, adding speedwork or hills, changing surfaces, returning after time off, switching shoes suddenly, or lacking enough lower-leg strength.
You may be able to keep running if symptoms are mild, don’t worsen during the run, don’t change your gait, and settle by the next day. If pain is sharp, focal, worsening, painful with walking, or present at rest, stop running and get assessed.
There is no single best running shoe for shin splints. Look for a shoe that feels comfortable while running, matches your injury history, and doesn’t create new symptoms. Avoid sudden changes in heel drop, stack height, stiffness, or support while your shins are irritated.
Helpful exercises often include progressive calf raises, tibialis posterior calf raises with a ball squeezed between the heels, tibialis anterior raises, foot control work, and single-leg strength exercises such as step-downs or split squats.
Get shin pain checked if it is sharp, very focal, worsening, painful at rest or at night, painful with walking, associated with swelling, or if hopping on the leg causes significant pain. These signs may suggest a bone stress injury rather than simple shin splints.
References
Anderson, L. M., Martin, J. F., Barton, C. J., & Bonanno, D. R. (2022). What is the Effect of Changing Running Step Rate on Injury, Performance and Biomechanics? A Systematic Review and Meta-analysis. Sports medicine – open, 8(1), 112. https://doi.org/10.1186/s40798-022-00504-0
Hoenig, T., Hollander, K., Popp, K. L., Fredericson, M., Kraus, E. A., Warden, S. J., Tenforde, A. S., & Bone Stress Injury Authorship Group (2025). International Delphi consensus on bone stress injuries in athletes. British journal of sports medicine, 59(2), 78–90. https://doi.org/10.1136/bjsports-2024-108616
Naderi, A., Fallah Mohammadi, M., Heidaralizadeh, A., & Moen, M. H. (2025). Effects of Integrating Lower-Leg Exercises Into a Multimodal Therapeutic Approach on Medial Tibial Stress Syndrome Management Among Recreational Runners: A Randomized Controlled Study. Orthopaedic journal of sports medicine, 13(2), 23259671241311849. https://doi.org/10.1177/23259671241311849
Relph, N., Greaves, H., Armstrong, R., Prior, T. D., Spencer, S., Griffiths, I. B., Dey, P., & Langley, B. (2022). Running shoes for preventing lower limb running injuries in adults. The Cochrane database of systematic reviews, 8(8), CD013368. https://doi.org/10.1002/14651858.CD013368.pub2
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
Schuster Brandt Frandsen, J., Hulme, A., Parner, E. T., Møller, M., Lindman, I., Abrahamson, J., Sjørup Simonsen, N., Sandell Jacobsen, J., Ramskov, D., Skejø, S., Malisoux, L., Bertelsen, M. L., & Nielsen, R. O. (2025). How much running is too much? Identifying high-risk running sessions in a 5200-person cohort study. British journal of sports medicine, 59(17), 1203–1210. https://doi.org/10.1136/bjsports-2024-109380
