Shin splints: why your shin hurts when running and how to fix it

Over the past three weeks you’ve been adding kilometres and you’ve started to feel a dull ache along the inner edge of your shin. At first it eased off once you warmed up. Now it shows up sooner, lasts longer, and doesn’t let you enjoy the long run. Welcome to the club of shin splints, one of the most common injuries among recreational runners.

This article is for you if you run regularly (beginner or intermediate level), have increased your training load in recent weeks, and want to understand what’s happening, how long recovery will take, and how to keep it from coming back. If you’re an advanced runner, you’ll also find useful guidance in the return-to-running phases.

What shin splints are

Shin splints —known in Spanish as periostitis tibial or, more precisely in clinical terms, medial tibial stress syndrome— is an inflammation of the periosteum, the layer of tissue that covers the tibia. It appears when the tibia and the muscles that attach to it (tibialis posterior, soleus, toe flexors) are subjected to more load than they can tolerate.

It is not a serious injury, but it is very persistent if you ignore it. According to a review published in British Journal of Sports Medicine (Winters et al., 2013), it affects 13-20% of runners at some point and accounts for up to 35% of overuse injuries in the lower extremity.

Symptoms: how to know if it’s shin splints

The typical picture is quite recognizable:

Diffuse pain along the inner edge of the tibia, usually in the middle-to-distal third.
Discomfort at the start of a run that sometimes improves as you warm up and returns after you finish.
Tenderness when pressing with a finger along the tibia (an area of 5 cm or more).
No clearly visible swelling, although there may be slight redness.

Telling them apart from a stress fracture

Here lies the clinical key. If the pain is localized (you can point to one exact spot with a finger), increases when you jump on one leg, or wakes you at night, suspect a stress fracture. You need an MRI and must stop. This is non-negotiable.

Telling them apart from compartment syndrome

Chronic exertional compartment syndrome causes pain that appears always at the same kilometre and disappears quickly when you stop, sometimes with tingling or transient foot drop. It is less common and requires specialist assessment.

Why it appears: the real causes

Shin splints almost never have a single cause. They are usually the sum of several factors:

Sudden increase in load. The 10% weekly rule is not sacred, but increases above 20-30% multiply the risk (Nielsen et al., Journal of Orthopaedic & Sports Physical Therapy, 2014).
Hard surfaces. Running always on asphalt adds up cumulative impact.
Inadequate or worn-out footwear. More than 600-800 km in the same shoe reduces cushioning.
Biomechanics. Very pronated foot strike, weak hips, ankle with limited dorsiflexion.
Weakness of the tibialis posterior and soleus.
Recent changes: of surface, of shoe (especially lowering the drop), of paces, or of volume.

If you’ve just started wearing shoes with less cushioning or have switched from asphalt to trail, also check our guide on shoe drop.

Phased treatment

There are no shortcuts. There is a process, and respecting it determines whether you return in 3 weeks or in 3 months.

Phase 1 (days 1-7): calm it down

Relative rest: no running. You can walk without pain.
Ice for 10-15 minutes, 2-3 times a day after activity.
Anti-inflammatories only if your doctor indicates it; there is limited evidence that they speed up recovery.
Non-impact cardio: cycling, elliptical, swimming. RPE 5-6/10.

Phase 2 (weeks 2-4): strengthen

Eccentric exercises for the soleus and tibialis posterior (see next section).
Hip and gluteus medius work.
Ankle mobility (knee-to-wall test: at least 10 cm).
Continue not running if you feel pain on the tibia when palpated.

Phase 3 (week 4 onward): progressive return

Start with walk-run: 1 minute jog / 2 minutes walk × 8-10 sets.
Increase volume by no more than 10% per week.
Return to pace before distance.
Soft surfaces for the first 15-20 days.

Typical time off: 2-8 weeks in mild-to-moderate cases. Chronic cases, longer.

Evidence-based prevention exercises

Work these 4 movements 2-3 times a week:

Heel raises with bent knee (soleus): 3×15, slow.
Heel raises off a step (calf): 3×12, lowering for 3 seconds.
Tibialis anterior against an elastic band: 3×20.
Side bridge with hip abduction: 3×10 per side.

Add a specific warm-up before running. You can find more detail on this point in warming up before training.

Common mistakes

Running “because it doesn’t hurt much”. Every session on inflamed tissue delays recovery.
Stretching the calf as the only remedy. It helps, but without strength it won’t fix the problem.
Switching shoes in the middle of a flare-up. Stabilize first, change later.
Returning to your previous pace on day one. The tibia takes weeks to remodel bone.
Ignoring the hip. A weak gluteus medius shifts tension onto the tibia.

When to see a doctor without fail: localized, pinpoint pain, pain at night, pain that doesn’t improve after 10-14 days of relative rest, or if you are a woman with amenorrhea (increased risk of stress fracture).

What to do tomorrow morning

Stop running for 5-7 days and substitute cycling or swimming for the same weekly time.
Start today with the 4 strength exercises: 15 minutes, every other day.
Check the kilometres on your shoes and note the weekly increase over the last 4 weeks. If you exceeded 20%, there’s your cause.

FAQ

Can you run with shin splints?

Running with active pain worsens the injury and lengthens recovery. You can maintain fitness with non-impact activities (cycling, swimming, elliptical). You only return to running when you can palpate the tibia without pain and walk for 30 minutes without discomfort.

How long do shin splints last?

In mild cases detected early, 2-4 weeks. In moderate cases, 4-8. If you’ve ignored it for months, it can last 3-6 months. The deciding factor is not the initial severity, but how long you take to stop and to work on strength.

How do shin splints heal completely?

By combining three things: initial unloading (stopping running), strengthening of the soleus, tibialis posterior and hip, and progressive return with controlled load increases. No passive treatment (massage, ultrasound, taping) cures it on its own, although they can accompany the process.

Do compression socks help with shin splints?

They can relieve symptoms during and after running, but they don’t treat the cause. The evidence for their preventive effect is limited (Menéndez et al., Journal of Sports Sciences, 2020). Use them as a complement, never as a substitute for strength work.

What shoes are best if I have shin splints?

During recovery, prioritize known cushioning and stability: keep the model you weren’t injured in. Avoid abrupt changes in drop or foot-strike type while symptomatic. Switching shoes in the middle of an injury usually makes things worse.