Shin Splints in Runners

January 27, 2025

MEDIAL TIBIAL STRESS SYNDROME (SHIN SPLINTS) IN RUNNERS


THE INJURY

Shin splints or shin pain is clinically referred to as medial-tibial stress syndrome (MTSS). It is an umbrella term that often refers to a number of issues involving pain in the shin area. At their worst, shin splints can turn into a stress fracture along the tibia, and searing pain will

be felt with every stride. In less severe cases, the muscles and tendons in the shin area may be tender and inflamed, or even develop micro tears near their attachment to the tibia (shin bone); often pain lessens a few miles into the run and builds up again towards the end of

a run or afterwards. Either way, shin pain is a sure-fire way to make your running experience markedly unenjoyable and accounts for approximately 15% of running injuries.


THE SYMPTOMS

1. Pain along the front and medial (inner) side of the tibia (shin bone).

2. Mild cases - pain after running.

3. Moderate cases – pain on impact as foot

strikes the ground.

4. Severe cases - pain standing or just walking

without any impact.

5. Pain on palpation along the inside edge of

the tibia. Pain when squeezing/compressing the calf muscle and anterior shin together.


THE CAUSES

Shin pain can most often be traced back to a sudden spike in training volume and intensity. Recent studies indicate the trauma isn’t caused by the direct contact of muscles attaching to the bone. Instead it happens from the slight bend that occurs during activity in a stress-loaded bone. As your tibia and surrounding muscles strengthen with repeated high-impact activity, the chance of shin splints lessens. Hence why shin splints are more common in those just starting or returning to a running programme. They are also a sign you could be wearing the wrong shoe or worn out shoes. Running on hard surfaces also increases your risk of developing shin splints. A high BMI and being female are added risk factors for shin splints.


THE FIX

When the first twinges of pain strike, reduce your running to a comfortable level for a few days to a week, then slowly increase your mileage using the 5-10% rule (no more than a 10% increase per week). Cross train with cycling, pool running, and swimming.


Include:

1. Rest, ice, and ibuprofen

(non-steroidal anti- inflammatories) to ease the pain.

2. Taping the shin can

relieve pain and speed healing. Taping or bracing provides compression to

aid relief, but also stabilises the ankle so the shin muscles don’t have to work so hard to support your leg.

3. Physical therapy including mobilisation,

massage, and acupuncture can

all promote tissue

healing and mobilise surrounding tight structures.

4. Provided you are pain free when performing exercises, you should do flexibility/mobility activities for your ankle, calf and hip. Followed by strengthening exercises for the entire leg which may include squats, bridging and balance activities.


THE PREVENTION

The easiest and best way to avoid shin splints is to increase mileage gradually, and mix your training surfaces from concrete or asphalt to grass or trails. If you have high arches and a rigid foot then you may need shoes with added support and cushioning. Work towards having good mobility and stability, not just throughout your ankle and lower leg, but in your entire body. Strength with mobility means the entire kinetic chain can work together for maximum running efficiency, so take the time to do strengthening exercises daily. Remember a dynamic warm up before a run may prepare better your body for the impact of running.

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When an injury affects your child’s sport, play or everyday activities, it can be difficult to know what to do next. At Weaver Physiotherapy & Sports Injury Clinic, we offer assessment and rehabilitation for children and young people with sports-related and musculoskeletal problems. Based in Northwich, our clinic welcomes families from across Cheshire, including Tarporley, Knutsford, Winsford, Middlewich, Hartford, Weaverham, Sandbach and Frodsham. You can contact us directly to discuss your child’s symptoms and arrange an appointment; a GP referral is not required to book privately. A physiotherapy assessment considers the injury, your child’s movement and the activities they want to return to. Treatment and rehabilitation are then discussed in light of their needs and assessment findings. What happens at a child’s sports injury assessment? The appointment begins with a discussion about when the problem started, what activities affect it and how it is changing your child’s movement. We may ask about their usual sport, training routine, recent changes in activity and relevant medical history. The practitioner will then assess the affected area and relevant movement and function. This helps explore possible causes and identify appropriate next steps. Depending on your child’s presentation, the plan may include advice, a tailored exercise programme and hands-on treatment where appropriate. Treatment is individual . The approach will depend on the assessment findings, your child’s symptoms and how they respond to activity. If rehabilitation is recommended, exercises can be progressed to support comfortable movement and a gradual return to sport. Sports injuries and pain we can assess Children and teenagers may develop pain or injury after a sudden movement, a knock or a change in training. Assessment may be appropriate for concerns involving the: Back, hip or knee Ankle or foot Shoulder, elbow, hand or wrist Sports-related problems can include sprains, strains, tendon pain and injuries associated with repeated loading. Your child’s symptoms and activity will guide the assessment, rather than focusing only on the painful area. If you have noticed a change in your child’s posture or are concerned about a possible spinal curve, speak to your GP. The NHS advises contacting a GP if you think your child may have scoliosis. Read NHS guidance on scoliosis ⁠. Booking an appointment Please contact Weaver Physio to discuss your child’s symptoms and arrange a suitable appointment. Same-day appointments depend on availability, so please book ahead rather than relying on a walk-in consultation. When you get in touch, it can help to explain: When the symptoms began Which movements or activities make them better or worse Whether the problem affects walking, sleep, school, training or sport Any relevant medical history or recent changes in activity It can also help to let your child describe how the problem feels in their own words. Please bring comfortable clothing that allows movement to be assessed. Weaver Physiotherapy & Sports Injury Clinic 110 Middlewich Road, Northwich, Cheshire, CW9 7DP Call 01606 227484⁠ or visit weaverphysio.com ⁠. Free onsite parking is available. When to seek urgent medical help A physiotherapy appointment is for non-emergency musculoskeletal concerns. If your child has a serious injury, or you are unsure whether they need urgent care, use NHS guidance or contact NHS 111. The NHS advises taking a child to A&E or an urgent treatment centre if they have an arm or leg injury and cannot use the limb. Read the NHS guidance on children’s accidents . For information about checking an individual physiotherapist’s registration, visit the HCPC Register ⁠. Frequently asked questions Do we need a GP referral? No. You can contact the clinic directly to ask about booking a private appointment for your child. Do you accept walk-ins? Please book an appointment in advance. Same-day consultations may be available, depending on the clinic schedule. What should my child wear? Comfortable clothing that allows them to move freely is helpful for the assessment. Do you provide scans? Scans are not included in every clinic appointment. If further investigation appears appropriate, this can be discussed with you and your child. How much does an appointment cost? Please contact the clinic for current fees and to discuss the appointment that may be suitable for your child. Discuss an appointment for your child If pain or an injury is affecting your child’s movement, sport or usual routine, contact Weaver Physiotherapy & Sports Injury Clinic to discuss an assessment in Northwich. We’ll talk through your concerns and the possible next steps for your child.
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Have you ever been told that your running style is “wrong” and immediately wondered whether you need to change it? Advice online can make normal differences in movement look like faults. While certain running habits may be worth exploring—particularly when pain keeps returning—there is no single perfect stride, cadence or foot strike for every runner. At Weaver Physiotherapy & Sports Injury Clinic, we take an individual approach to running technique. Your training history, symptoms, strength, mobility, goals and the way you respond to load all matter. For runners in Northwich, Middlewich, Winsford, Knutsford, Sandbach, Frodsham and Tarporley, our Runner’s MOT and running gait analysis⁠ provides clear, personalised feedback rather than generic rules. What are common running form mistakes? A “running form mistake” is often better described as a movement habit to investigate. A pattern may look unusual without being harmful, and a video alone cannot confirm that it is the cause of pain. Common concerns include: Overstriding – the foot appearing to land well ahead of the body. Upper-body tension – raised shoulders, clenched hands, a tight jaw or stiff arm swing. Forcing foot strike – deliberately trying to run on the forefoot or heel when it feels awkward. Slumped posture – losing trunk control as fatigue develops. Abrupt changes in technique – trying to alter cadence, posture and foot strike at the same time. These patterns can change with pace, hills, footwear, fatigue, confidence and training load. Research has found limited evidence that individual biomechanics alone predict running injury, which is why form should be considered alongside the wider picture rather than treated as a diagnosis. Is there one correct way to run? No. Effective running does not look identical from person to person. Your anatomy, strength, experience, speed, terrain and fatigue level all influence your stride. A single photograph or short clip captures only one moment. It cannot explain how you feel during a run, what your training has involved that week, or whether a movement pattern is actually contributing to symptoms. If you are comfortable, progressing well and free from persistent pain, you may not need to change your technique simply because it differs from someone else’s. The aim is not to chase a “perfect” running style. It is to understand your own movement and make sensible adjustments only when they are relevant to your goals or symptoms. How to assess your running form safely Start with one question. Perhaps your foot feels as though it reaches too far forwards, your shoulders tighten on longer runs, or you notice discomfort appearing as you fatigue. During an easy run at your usual pace, consider: Does your breathing feel relaxed? Are your shoulders, hands and jaw unnecessarily tense? Does your stride feel comfortable and natural? Does your movement alter later in the run? Is there recurring pain during, after or the following day? If you use video, record a brief clip from a safe, consistent position beside the route or on a treadmill. Never hold or watch a phone while running. Footage can be useful for observation, but it should prompt questions—not provide a self-diagnosis. How to change running technique without overdoing it Avoid making dramatic changes based on a social-media tip or a one-size-fits-all rule. A sudden change in cadence, posture or foot strike may feel unnatural and can make it difficult to work out what is helping. Instead: Choose one area to explore. Use one simple cue during an easy run. Keep the adjustment gentle and brief. Notice how it feels during the run and over the next 24–48 hours. Do not introduce several technique changes at once. For example, if you feel tense through the upper body, a helpful cue may be “soft shoulders and easy arms” rather than forcing a rigid posture. If you are concerned about stride length, focus on a light, comfortable rhythm rather than trying to land in a prescribed position. Training progression matters too. Increasing distance, pace, hills and frequency too quickly can overload tissues, regardless of how your running looks. NHS advice recommends building running gradually and listening to pain rather than pushing through it. Read the NHS guide to common running injuries ⁠. When should you seek individual running advice? Consider a running assessment if pain: Keeps returning or becomes more severe Changes the way you run Persists after reducing or adapting training Is associated with swelling, weakness, limping or a loss of confidence Leaves you unsure which changes, if any, are appropriate Sudden severe pain, inability to bear weight, major swelling, numbness, deformity or a suspected serious injury should be assessed urgently. NHS guidance on sprains and strains explains when to seek urgent help. What can running gait analysis help with? A running gait analysis does not promise to predict injury or reveal one universal correction. It can, however, provide a clearer view of movement patterns in the context of your symptoms, training and goals. At Weaver Physio, our Runner’s MOT (/runners-mot)⁠ combines slow-motion video gait analysis with strength, mobility and movement assessment. We look at factors such as: Running rhythm and lower-limb control Trunk, hip, knee and foot movement Strength, balance and mobility Previous injuries and current symptoms Training volume, recovery and running goals Your findings are then used to create practical, personalised recommendations. This may include a gradual gait cue, running-specific strength work, mobility exercises, load-management advice or a structured return-to-running plan. Our Chartered Physiotherapists and Sports Rehabilitators bring more than 70 years of combined clinical experience to help runners move with greater understanding and confidence. Build a stronger, more confident running stride Running form is not a test you have to pass. A movement pattern may be worth exploring, but it does not automatically mean that something is wrong. Pay attention to comfort, recurring symptoms and changes that develop with fatigue. Make adjustments gradually, progress training sensibly and seek individual support if pain continues. For runners across Northwich and Cheshire, Weaver Physio’s running gait analysis service (/runners-mot)⁠ offers professional, tailored guidance to help you run stronger and with more confidence. Frequently Asked Questions Is there one correct running form for everyone? No. There is no single ideal foot strike, cadence or posture that applies to every runner. Comfortable, efficient running can look different depending on the individual, their pace, experience and physical characteristics. Can changing my running form cause pain? It can. Sudden or uncomfortable changes may increase stress in unfamiliar areas. Make one gradual change at a time and reduce or stop if pain worsens. How can I tell if I overstride? Overstriding may appear as the foot landing well ahead of your body, but this does not automatically mean it is causing a problem. A short video can provide useful context, while a gait assessment can help interpret the pattern alongside your symptoms and training. When should I book a running gait analysis? Book an assessment if pain is recurring, your running style has changed, you are returning from injury, or you would like clearer guidance about your stride and training. Weaver Physio supports runners from Northwich, Middlewich, Winsford, Knutsford, Sandbach, Frodsham, Tarporley and across Cheshire.
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