If you’re experiencing pain along the inside of your shin during or after running, football, rugby or other impact sports, you may have Medial Tibial Stress Syndrome (MTSS) – commonly known as shin splints. It’s one of the most common overuse injuries in runners and athletes and often develops when training loads increase faster than the body can adapt.
The good news is that most cases respond extremely well to early physiotherapy and a structured rehabilitation programme. At Great Northern Physiotherapy, we’ll identify why your shin pain has developed, address the underlying causes and help you return to running and sport safely, with less risk of recurrence.
Symptoms
Shin splints usually develop gradually rather than after a single injury. Pain is typically felt along the inside border of the shin bone (tibia) and often becomes more noticeable during running or jumping activities.
Common symptoms include:
- Pain along the inner edge of the shin
- Tenderness when pressing on the affected area
- Aching during running or impact exercise
- Pain that settles with rest but returns during the next session
- Tightness in the lower leg
- A bruised or sore feeling despite no visible injury
- Discomfort when increasing training intensity or distance
In the early stages, symptoms may only occur during exercise. If left untreated, pain can begin earlier during activity or even persist during everyday walking.
Causes
Medial Tibial Stress Syndrome is an overuse injury caused by repeated loading of the shin bone and surrounding tissues. Running, jumping and other impact activities place stress through the tibia, and if the body doesn’t have enough time to adapt, the bone covering (periosteum) and attached muscles can become irritated.
Common contributing factors include:
- Sudden increases in running distance or intensity
- Changes in training programmes
- Returning to sport too quickly after injury
- Running on harder surfaces
- Poor lower limb strength
- Biomechanical abnormalities
- Inappropriate footwear
- Reduced recovery between training sessions
Several factors often combine to overload the tissues, which is why identifying the underlying cause is essential for successful treatment.
Diagnosis
A thorough physiotherapy assessment is usually all that’s required to diagnose Medial Tibial Stress Syndrome.
During your appointment, we’ll discuss:
- When your symptoms began
- Recent changes in training
- Your running history
- Footwear
- Previous injuries
- Sporting goals
We’ll then assess:
- Walking and running biomechanics
- Lower limb strength
- Foot posture
- Ankle mobility
- Balance and control
- Tenderness along the shin
Our advanced gait analysis technology allows us to assess your movement in detail, helping identify loading patterns that may be contributing to your symptoms.
If your symptoms suggest a stress reaction or stress fracture rather than shin splints, further investigations such as diagnostic ultrasound or MRI may be recommended.
Treatment Options
Comprehensive Physiotherapy Assessment
Successful treatment begins by understanding why your tissues have become overloaded.
Our assessment looks beyond the painful area to identify movement patterns, strength deficits and training errors that may be contributing to your symptoms.
Progressive Rehabilitation
Exercise is the foundation of successful recovery.
We’ll guide you through a progressive rehabilitation programme that restores strength, improves load tolerance and prepares you for a safe return to running.
Your programme may include:
- Calf strengthening
- Hip and glute strengthening
- Lower limb stability exercises
- Balance training
- Plyometric progression
- Running-specific strengthening
- Return-to-running programmes
Every programme is tailored to your sport, fitness level and recovery goals.
Biomechanical Assessment
Running mechanics play a significant role in managing shin splints.
Using advanced gait analysis, we assess how you move during walking and running to identify factors that increase stress through the shin.
Where appropriate, we may recommend:
- Running technique modifications
- Footwear advice
- Training adjustments
- Bespoke orthotic assessment
Optimising movement can significantly reduce the risk of symptoms returning.
Shockwave Therapy
For persistent cases that haven’t responded fully to exercise alone, Shockwave Therapy may be recommended.
Shockwave stimulates blood flow and the body’s natural healing response, helping reduce pain while supporting tissue recovery. It is supported by research for the management of chronic Medial Tibial Stress Syndrome.
Self-management
Managing your training load is one of the most important aspects of recovery.
We often recommend:
- Temporarily reducing painful running or jumping activities
- Following your rehabilitation programme consistently
- Gradually rebuilding running distance
- Avoiding sudden increases in training volume
- Wearing appropriate footwear
- Allowing adequate recovery between sessions
- Maintaining strength training alongside running
Completely stopping activity is rarely necessary. Instead, we aim to modify your training while maintaining fitness wherever possible.
Recovery Timelines
Recovery depends on how long symptoms have been present and how much the tissues have been overloaded.
Typical recovery times include:
- Mild symptoms: 4–6 weeks
- Moderate cases: 6–10 weeks
- Persistent symptoms: 3 months or longer
Starting treatment early usually results in a quicker recovery and reduces the risk of progression to a stress reaction or stress fracture.
When to Seek Help
Arrange an assessment if:
- Shin pain continues to return during running
- Pain is limiting your training
- Symptoms aren’t improving with rest
- You want guidance on returning to sport safely
- You’re unsure whether you have shin splints or another injury
Seek prompt medical advice if:
- Pain becomes severe enough to affect walking
- You develop a very specific area of bone tenderness
- Pain occurs at rest or during the night
- Symptoms follow a significant injury
These symptoms may suggest a stress fracture and should be assessed as soon as possible.
Clinically Reviewed By
Phil Williams
Director and Consultant Physiotherapist
Get Back to ACTIVITY with Confidence
Shin splints don’t have to keep you on the sidelines. With the right diagnosis, progressive rehabilitation and expert guidance, most people make a full return to running and sport.
Our experienced physiotherapists will identify what’s causing your symptoms, optimise your movement and support your recovery every step of the way.
Book your initial assessment today and take the first step towards pain-free running.
SHIN PAIN FREQUENTLY ASKED QUESTIONS
No. Although the symptoms can be similar, shin splints involve irritation of the tissues around the shin bone, whereas a stress fracture is a small crack within the bone itself. Our assessment helps distinguish between the two.
Not always. Many runners can continue training with appropriate modifications while following a structured rehabilitation programme.
Yes. Addressing strength deficits, biomechanics and training errors significantly reduces the risk of recurrence.
Not everyone does. If your assessment identifies biomechanical factors contributing to your symptoms, orthotic support may be beneficial as part of a broader rehabilitation programme.
Research supports the use of Shockwave Therapy for persistent cases of Medial Tibial Stress Syndrome, particularly when combined with progressive exercise rehabilitation.
Related PHYSIO SERVICES
To support your recovery, your physiotherapist may recommend one or more of our related services:
Book your initial assessment and take the first step toward pain-free movement.