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Shin Splints (Medial Tibial Stress Syndrome)

Sports and Activity-Related Conditions· Also known as: shin splints, MTSS, tibial periostitisUpdated Nov 2026

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At a Glance

Shin splints (medial tibial stress syndrome) is an overload problem of the shin that brings a dull, aching pain along the inside of the shinbone, typically when you exercise. It is common in people who run or jump a lot, with between 4 and 35 per cent affected, though figures vary. Home care often brings improvement in a few weeks, though how long recovery takes differs between people and can be lengthy. Changing your activity early helps stop it getting worse.

What is it?

Shin splints is the everyday name for medial tibial stress syndrome (MTSS). It is an overuse problem, which means doing more than your legs are ready for. It causes pain and tenderness along the inner edge of your shinbone (the tibia), usually a dull ache that starts with exercise.

In some cases it can get in the way of daily activity and sport. If you have an ache along the inside of your shin that starts when you exercise, treat it as a real injury that needs attention. Don't assume it will go away on its own.

Who does it affect?

Shin splints are common, especially in people who are active. They are one of the most common causes of leg pain with exercise, and one of the most common overuse injuries of the lower leg.

They mostly affect people who load their legs again and again, such as runners and people who play running and jumping sports. Athletes and military personnel who run and jump a lot are also often affected.

Figures vary, but between 4 and 35 per cent of people in these groups may be affected at some point.

Signs and symptoms

The main sign of shin splints is a dull, aching pain along the inner edge of your shinbone. You can usually feel it over a large stretch of your shin, more than 5 cm across, and most often in the lower part. It often affects both legs.

The pain tends to begin soon after you start exercising. It may get worse afterwards, then ease gradually with rest. It can come back when you start being active again.

The area may be sore when you press on it, and there may be mild swelling along the shin.

Pain in one small spot is different. It may be a stress fracture (a small crack in the bone) rather than shin splints. If your pain is like this, see the 'When to see a podiatrist' section.

What causes it?

Running, jumping and other repeated weight on the legs are the usual triggers. Exercising beyond your current fitness is one of the most common reasons for the pain.

The exact cause isn't known. Repeated stress on the shinbone has long been thought to cause swelling (inflammation) in the tissue around the bone. More recent thinking is that it is more likely a stress reaction in the bone itself. Both ideas may be part of the picture, with the bone taking more load than it can repair.

Some people with shin splints have been found to have lower bone density in the sore part of the shinbone, which returned to normal once their symptoms stopped.

Having less muscle bulk around the lower leg is a likely risk factor. Other risk factors are still unclear.

How is it diagnosed?

Shin splints can usually be diagnosed by asking about your symptoms and examining your leg. The story of your pain matters most. Before your visit, note when it began, whether it comes on with activity, at rest or at night, what makes it better or worse, and whether it disturbs your sleep.

Other problems can feel similar, including a stress fracture, compartment syndrome, and nerve or artery problems in the leg. This can make diagnosis tricky.

Tenderness spread along the inner shin without swelling points to shin splints rather than a stress fracture. Pain in one small spot points more towards a stress fracture, especially after a recent increase in activity or repeated activity with little rest.

Scans are used to confirm what the examination suggests, not to replace it.

Treatment

Care for shin splints starts at home, often with help from your podiatrist. It isn't yet clear which treatment works best. So the aim is to find and ease whatever is overloading your legs.

Looking after it at home

The main step is to ease off or change the activity that brings on the pain. Once it settles, build back up gradually.

Don't push through the pain. Shin splints often begin as a mild ache with exercise. If you keep training without changing anything, it can turn into a more constant pain. Spotting it early and adjusting what you do makes a real difference.

Treatment from your podiatrist

Your podiatrist will look for things that may be overloading your shins. These include how much you are training, how you walk and run, your footwear, and how your feet move. Together you can then work on correcting them. Your physiotherapist can also help with this.

Surgery

Surgery is only considered for stubborn cases that haven't settled after other care.

Recovery

Shin splints can usually be treated at home, and many people start to feel better within a few weeks. Recovery time varies, though, and for some people it can be a long road.

If you ignore the pain or keep training exactly as before, it can get worse over time. A mild ache can turn into a more constant pain, and in severe or long-lasting cases it may lead to a stress fracture in the shinbone.

When you return to training, do it gradually. If mild pain comes back, change your load rather than carrying on unchanged.

Preventing it

Build up your running or jumping load gradually.

Neuromuscular training (exercises that train muscle control and balance) can lower the chance of shin splints starting. So can shoe inserts (insoles) for people with overpronation, which means the feet roll inwards. Ask your podiatrist or physiotherapist whether these suit you.

Where you can, run on softer surfaces such as grass or sand rather than concrete or asphalt. Hard surfaces may raise the risk, but this isn't proven.

It isn't yet clear what stops shin splints coming back after you have recovered.

When to see a podiatrist

When to book

Book an appointment with your podiatrist if:

your pain hasn't improved after a few weeks of home care
your symptoms keep coming back
you have pain in one spot on a bone that has built up over a few weeks of running, jumping or other impact, or gets worse if you keep going

When to get help sooner

See your podiatrist or GP soon if:

you have new numbness, tingling, pins and needles or weakness in your foot that has come on gradually
you get aching or cramping in your calf, thigh or foot when you walk that eases when you rest
your pain is getting worse, or doesn't settle with rest, less activity or pain relief

Frequently asked questions

Are shin splints and medial tibial stress syndrome the same thing?

Mostly, yes. Some people use shin splints more broadly, for any pain along the shinbone from knee to ankle. Medial tibial stress syndrome refers to pain along the inner edge of the shinbone.

Do I need an MRI for shin pain?

Not usually. Shin splints is mostly worked out from your story and an examination. An MRI scan is the main way to diagnose a bone stress injury, such as a stress fracture, and it is used to confirm what the examination suggests.

Can I keep running while it's sore?

Don't run through the pain, especially while the cause is still being worked out. Ease off or change what you do instead. If the pain isn't settling, check the 'When to see a podiatrist' section above.