Shin splints, aka medial tibial stress syndrome, is a condition characterized by inflammation of the connective tissue joining the muscles to the shin bone (tibia). Every time the calf contracts it pulls on the deep muscles connected to the tibia. When this is too forceful or too repetitive damage can occur resulting in pain through the shins.

Shin pain in the bottom half of the leg is common among runners, netballers etc. Pain is usually located on the inside (medial) aspect of the shin but can occur on the outside (lateral). Occasionally this pain may become severe and limit athletic performance.

Shin pain typically will decrease during warm-up allowing you to train/compete, but then returns after activity. Shin pain is associated with overuse (such as an increase in training or in running) and it frequently occurs in association with muscle tightness and/or biomechanical abnormalities.


Shin pain can be caused by a number of events:

  • Excessive training;
  • Inappropriate footwear;
  • Training on hard surfaces;
  • Muscle weakness through the foot, calf, lower leg or pelvis resulting in poor lower limb biomechanics;
  • Being overweight.

What do I feel?

  • Deep dull pain in the lower half of the shin. There may also be sharp pain in this area;
  • Pain during warm up and then again after activity. Pain may be worse the following morning;
  • Impaired walking or athletic performance due to decreased tolerance to load;
  • The muscles in the shin may be tender to touch;
  • Some people may also develop an apparent limp.

What can I do?

Treatment can include activity avoidance for the first few days, icing and the use of anti-inflammatory medication. It may also be recommended to modify your footwear/have your foot mechanics reviewed by a professional.

Physiotherapy techniques may also be useful in reduction of pain and improvement in function. The therapist may use a variety of approaches to treat the problem.

Techniques can include:

  • Dry needling;
    • Trigger point therapy;
    • Deep tissue massage;
    • Ergonomic and activity advice;
    • Sustained myofascial release;
    • Education on orthotics/footwear.

Treatment will usually be accompanied by a home exercise programme to address some of the mechanical predispositions that the individual may have, this will typically include pain controls and a series of stretching and strengthening exercises. Shin pain is often poorly diagnosed, making it important to get a correct assessment from your health professional.

This information is intended as a guide only. For specific information regarding injury assessment and management, you should always consult your health professional.