Why Do My Shins Hurt?

I was inspired to write this blog article after seeing a bunch of high level athletes at my football club develop persistent shin splints during pre-season. Some of these injuries are still recurring during the season and have had some debilitating outcomes on performance.

As a Podiatrist and an athlete, I would love to help you manage (and preferably avoid!) shin splints and provide you with some tips and insights into treatment strategies.

What are Shin Splints?

Shin splints, technically known as medial tibial stress syndrome (MTSS) refers to a dull aching pain experienced along the posteromedial border of the tibia/shin bone and is usually elicited with the onset of exercise or in the mornings. Muscles become overworked, creating microtears in the muscle belly and bone tissue. Shin splints are commonly encountered in high intensity sports requiring sudden changes in direction and can also present as an overuse injury in runners and sprinters. Excessive forces that the muscles are placed under cause the muscles to swell therefore increasing pressure on the tibia/shin bone.

Common symptoms:

  • Pain is commonly experienced on the front and on the medial/inside of the shins.
  • Pain is worse in the mornings and after exercise
  • Pain decreases as you warm up and stretch
  • Tight calves
  • Pain going up hills and sprinting
  • The area may be painful to touch

What causes shin splints?

Shin Splint is a common overuse injury that is caused by a combination between poor lower limb biomechanics and also excessive pressure through the region. “Too much too soon” is a common phrase used when referring to the cause of shin splints, meaning that a sudden increase in physical activity can lead to overuse injuries in muscular structures. Overpronation (rolling in) of the foot is another common cause of shin splints as this creates a muscle imbalance in foot pressure on the medial (inside) of the foot. This creates stress on the shinbone.

Other causes:

  • weakness in the glutes
  • worn-out and under-supportive footwear
  • training on hard surfaces
  • weakness in ankles
  • tight calf muscles/Achilles tendons
  • participation in high-intensity sports requiring sprinting or sudden changes in direction such as football, netball, basketball, soccer.

What can I do to treat my shin splints?

Depending on the severity of the condition and the stage of the shin splints, as well as how long you have had it for and the intensity of pain, I have outlined some strategies to treat your shin splints.

Tools that are required:

  • Lacrosse ball/ massage ball
  • Red theraband (medium resistance)
  • Foam roller

Modification in training load:

It is important to adjust training load, surfaces, intensity and frequency.

  • Training surfaces: In the early stages, try to avoid running on the road and opt for surfaces such as trails, grass and the treadmill in order to reduce the shock and load going through your legs.
  • Hills and sprints: Ensure that sprints and any hill work is avoided whilst the pain is still present as this can place more pressure underneath the area.

PHASE 1: Stretching & mobility

Depending on the symptoms and severity of the condition, stretching and mobility techniques are a great starting point.

  • Elevating and icing for 10 mins following training sessions
  • Calf stretches: Bent leg against the wall and also off a step, holding this for 15-20 seconds (see photo)
  • Glute stretches
  • Calf holds: Facing a wall and touching with your fingertips, go up onto your toes and hold for 30-40secs. Repeat this twice. There has been plenty of research behind this exercise being effective for pain-relief. (See photo)
  • Massage ball: Small rolls up and down and left to right can relieve taut bands in the tibialis anterior muscle and calf muscles.
  • Roller: Using the roller over the calf muscles and tibialis anterior muscle using the technique above can also assist with tight areas.
  • Avoiding hills and sprints: Whilst there is still pain, these should be avoided as they place more strain on the calves and shins.

PHASE 2: Strengthening

Usually the best rule of thumb is to commence strength training once the pain has subsided and is below a 5/10. Strengthening exercises are a great way to build up the capacity in the calf muscle and tibialis anterior leg muscles in order to physically prepare them for a full return to the sport.

By restoring the ability of the muscles to withstand more load and power, this can prevent the shin splints from reoccurring.

Calf raises: Facing a wall and holding with fingertips, go up onto your toes and back down. Start with 10-15 reps x 2 sets and increase reps and sets when this becomes comfortable.

If there is pain performing these resort to isometric calf holds- holding at the top on toes for 30secs x 2 sets.

Single leg calf raises: Following the instructions outlined above, these can be performed on one leg in order to increase the load through the structures.

Theraband exercises:

  • Dorsiflexion/plantarflexion: This targets the anterior (front) and posterior (back) muscle compartments. Lying down, place theroband at base of toes and point toes upwards and downwards. Repeat 10-15 times x 2 sets to start with.
  • Tibialis Posterior: Also strengthens the calf musculature, specifically the tib post tendon. Tie a knot in the theraband

How can I prevent this from reoccurring?

It is important to read your body and to allow yourself to rest when you experience niggles, aches and pains that prevent you from completing a full training session or run.

  • Manual therapy: Frequent soft tissue massage and dry needling through calves and tibialis anterior.
  • Self-massage: through the calves and tibialis anterior muscle using a roller and a massage ball.
  • Stretching: Following a stretching program to release calves, hamstrings and quads to offload pressure from the shins.
  • Strengthening program: This may involve theraband exercises: plantarflexion/dorsiflexion, isometric calf holds and then progressing to calf raises if there is no pain
  • Supportive footwear: Shoes with cushioning and arch support.
  • Modifications in training surfaces: Reducing running on the road and instead mix it up by running on trails, grass and the treadmill whilst there is still pain/discomfort.
  • Decrease the amount of hills and sprinting whilst there is pain.

What our clients are saying about us

Bree BrittBree Britt
05:41 22 May 24
Mehar was fabulous! Not only was she warm, welcoming and funny, but professional and thorough.From the moment I walked in I felt well supported. She was able to identify what was going on, factoring in older ailments, and provide me with a treatment plan and options.Her focus was on sustainable changes and support moving forward, and I had a written plan and clear explanations and clarifications on everything. I never felt like she was encouraging me to need to come back unnecessarily.It took a few visits, and each time was met with the same warmth and professionalism. I got consistent progress and feel so much better now, even though it's a few months on from when I last saw her.It's very clear she is wonderful at what she does, thinks about the whole person and I would definitely recommend her to others considering needing podiatry support.
Rose StewartRose Stewart
02:32 14 May 24
The whole client therapist experience has been amazing. My Myotherapist provided me with a detailed plan to ensure my progress to meet my goals as well as addressing my issues of pain.Each follow up session is reviewed, discussed and any changes added/deleted or modified.The timely reminders and follow up from the clinic and experience with the Client Experience Officers have been always polite and friendly.
Patrick MonahanPatrick Monahan
00:37 13 May 24
Mehar Sandhu has been an absolute delight. She is very professional in her treatment and most personable and friendly to deal with.
Yolanda OppyYolanda Oppy
03:13 10 May 24
Ezyk ArtistEzyk Artist
00:07 19 Apr 24
I've been coming here exclusively since my first consultation. I've had constant shoulder and arm pain from my line of work; the exercises my physio, Carina provided are easy to remember, not time consuming and super effective!Bonus: the space feels super clean and calming - highly recommend coming here
Natasha KhongNatasha Khong
23:58 22 Mar 24
I had a great experience here. The gym was well equipped and the atmosphere of the clinic was amazing. I had Carina, who was very knowledgeable about my injury and helped construct a great solution plan! Her manner was beautiful and she had great energy. Definitely recommend!
Annabel ChandlerAnnabel Chandler
20:28 14 Mar 24
I’ve been seeing Talia for a few weeks now for treatment on my shoulder bursitis. From day 1 she was great! She explained everything about my condition to me and what she wanted to do which helped me visualise my own recovery. Could not recommend her enough.
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