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Shin pain is common in runners, and is often given the name “shin splints”. There are a number of causes of shin pain in runners, so an accurate diagnosis is important to dictate appropriate treatment.

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What causes shin pain?

Whilst there are a number of causes of shin pain in runners (see blog here), but the most common cause is medial tibial stress syndrome (MTSS), which makes up 16% of all running injuries. (Mulvad 2018).

What are the symptoms of MTSS?


​Some of the symptoms experienced by those with medial tibial stress syndrome

  • Pain felt on the inside of the shin, usually an area of greater than 5cm, tender to touch

  • Both legs are often involved

  • Aggravated with running & jumping

  • Initially, pain may only occur at the beginning of the workout, disappearing after warming up, then returning post-exercise. As it gets worse, the pain can remain throughout the exercise and linger for hours to days afterwards.

  • No pins & needles or symptoms into feet

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What causes MTSS?​


Whilst the exact cause isn’t clear currently, some of the leading theories include the soleus (one of the calf muscles) excessively pulling on the tibia (shin bone) leading to overload. (Winters 2020).

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Managing shin pain


Firstly get a DIAGNOSIS! It’s important to know exactly what has been injured. Once you have a diagnosis, then get a PLAN moving forward! A thorough assessment by your health practitioner will ensure that treatment and rehabilitation can address any issues identified, and reduce the chances of you suffering another injury, and get you back out there as soon as possible.

It’s vital to see your health practitioner to firstly assess and diagnose your problem and secondly to create an INDIVIDUALIZED rehabilitation program.

One of the fundamentals in the management of MTSS is gradually increasing load. We do this through a gradual progression of plyometrics and running loads. 

See the video at the bottom of the page for some of our top tips on managing shin pain.

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Another key factor to address is the strength of the calf muscles. A previous study by Madeley found that those with MTSS had weaker calves, as measured on a single leg calf raise to fatigue test (see here). (Madeley 2007)


Strengthening the calf can help in two ways: 

1) stronger calf muscles assists in the absorption of impact forces & 

2) strengthening these muscles also improves tibial bone strength. (Hinton 2015, Hinton 2017)


It is also important to assess the other muscles of the legs and hip, as these have been found to be weaker in those with MTSS. (Verrelst 2014)

We use our state of the art AxIT system to assess if you have sufficient strength in these muscles. Read more about the AxIT system here.

Thorough health assessment

What is our unique approach to shin pain?

  • At Health & High Performance we pride ourselves on a thorough examination to ensure an accurate diagnosis to then lead to targeted treatment, allowing you to get back to your sport as soon as possible.

  • Firstly it is important to have a thorough discussion about your problem and some of the factors that may have contributed to it. This can include training errors (doing too much too soon & inconsistent training) or insufficient recovery (ie. high stress and poor sleep).

  • Using our state of the art technology, the AxIT system, we are able to measure strength to assist in predicting & guiding return to play. Read more about the AxIT system here.

  • Consideration of the role that other areas played in your injury: for instance, foot strength, low back pain, hip problems, or even previous ankle sprains may contribute to your injury. Your examination with us will cover all these areas, and your management plan will include solutions to these additional issues.

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Can you continue to run with shin pain?


Sometimes! In our experience, some runners can continue to run with modified training loads, whilst others do need some time off. Generally, we will try and keep runners going if they are able to keep pain below 4-5/10.

For tips on running with shin pain, head to our blog here.

Need further help?

Please don't hesitate to contact us for a thorough assessment of your shin issues & to formulate a plan to get you back to health & high performance!

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