REHAB & INJURY PREVENTION

Shin Splints: What to Do and How to Prevent Them

Medial tibial stress syndrome: acute management, the strength and surface fixes that prevent it, and the red flag that means see a doctor.

August 5, 20266 min read

Shin splints — medial tibial stress syndrome (MTSS) — is an overload response of the tibial periosteum, common when jump or run volume rises faster than the shin can adapt.

It is treatable, and usually preventable, if you fix the three drivers: volume jumps, training surface and shin strength.

Acute management

When shins hurt, do these first:

Cut training volume by 50% and substitute low-impact aerobic work (swimming, cycling, elliptical).
Ice 10–15 minutes, 2–3 times per day.
Strengthen the anterior shin: heel walking 3×30m, banded toe pulls 3×20.
Check shoes — running shoes typically last 500–800 km.

Prevention after recovery

Returning to training without fixing the cause guarantees a repeat. Address all three:

Progress volume gradually — weekly total jumps no more than +10%.
Choose surfaces — grass or rubber track over concrete.
Strengthen the arch with short-foot exercises and towel curls.

The red flag

If pain persists after 2 weeks of rest and reduced load, see a doctor to rule out a tibial stress fracture. Sharp, localized bone pain is not normal shin splints.

Key takeaways

Cut volume and substitute low-impact work while pain is acute.
Rebuild shin and arch strength before returning to full jump volume.
Pain persisting 2+ weeks after rest needs a medical check for stress fracture.

References

Moen et al. (2009) Sports Med
Warden et al. (2014) Br J Sports Med
Beck (1998) Am J Sports Med

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