My Shins Hurt When Running
Inner shin pain while running is most often medial tibial stress syndrome (MTSS). Commonly called ‘shin splints,’ it is an overuse injury.
What Is MTSS (Shin Splints)?
A condition in which repetitive stress builds up in the muscles and periosteum (bone membrane) attached to the inner tibia, causing inflammation.
Where It Occurs
It mainly occurs in the lower two-thirds of the inner tibia. Pain is felt over a wide area, more than 5cm long.
Muscles Involved
The posterior tibialis, flexor digitorum longus, and soleus attach to the tibia, and the problem develops as these muscles pull on it repeatedly.
Do You Have These Symptoms?
Inner Shin Pain
A dull pain is felt along the inner edge of the shinbone. It is not a single point but a wide area that hurts.
Pain When You Start Exercising
It hurts when you start running, and may ease off once your body warms up. It comes back again after exercise.
Tender When Pressed
Pressing the inner shin with your fingers produces tenderness. Several spots along the bone may hurt.
Morning Stiffness
Your shins may feel stiff and uncomfortable when you take your first steps after waking up.
Difference from a Stress Fracture
MTSS hurts over a wide area, but a stress fracture hurts very sharply at a single point. If the pain continues despite rest, or one point is extremely painful, you should suspect a stress fracture.
Why Does It Happen?
Sudden Jump in Training
Suddenly increasing your running distance, frequency, or intensity (especially for beginners)
Excessive Foot Pronation
Flat feet or an overpronation running pattern where the foot rolls inward too much
Weak or Tight Calf Muscles
Calf muscles that are weak or lack flexibility
Hard Surfaces
Repetitive running on hard surfaces such as concrete and asphalt
Improper Shoes
Running shoes with worn-out cushioning, or shoes that don’t suit your foot type
How Is It Treated?
If you ignore MTSS and keep running, it can worsen into a stress fracture. Treating it actively in the early stages is important.
Key: The hip (pelvis) muscles must be treated together
Treating only the shin leads to recurrence. When the glutes (hip muscles) are weak, the pelvis becomes unstable, and that impact is transmitted to the shins. Treating the shin and pelvis together is what works.
Treatment Goals
1. Relieve inflammation and tension around the shin
2. Restore calf muscle flexibility and strength
3. Strengthen the glutes (hip muscles) and restore pelvic stability, which is what really matters
4. Correct biomechanical problems in the foot and leg
Resolving MTSS with Circulation Treatment
We treat the shin and pelvis (hip) together
- Circulation HD. Calms inflammation in the fascia around the shin, calf, and glutes, and releases muscle tension
- Circulation PT. Calf stretching, glute strengthening, restoring pelvic stability, and correcting running form
Self-Care Tips
Adequate Rest
Stop running while you are in pain. Switch to low-impact activities like swimming or cycling.
Calf Stretching
Gently stretch the calf muscles (gastrocnemius, soleus). Two to three times a day is recommended.
Warm Compress
Apply a 15-20 minute warm compress to the shins after exercise. It boosts blood circulation and eases muscle tension.
Check Your Running Shoes
Make sure they have enough cushioning and suit your foot type. Replacing them every 500-800km is recommended.
When Should You See a Doctor?
• When pain persists even after more than 2 weeks of rest
• When one point is very painful or there is swelling (possible stress fracture)
• When it hurts just to walk
• When the pain keeps getting worse
Frequently Asked Together
Frequently Asked Questions
How is MTSS (medial tibial stress syndrome) different from a stress fracture?
MTSS is inflammation of the periosteum (bone membrane), so a dull ache is felt over a wide area of more than 5cm along the inner shin. A stress fracture, on the other hand, is concentrated at a single specific point with very intense tenderness. If pressing with one finger pinpoints exactly one spot that hurts severely, suspect a stress fracture and get checked quickly.
When should I see a doctor for shin pain after running?
If the pain does not settle even after resting fully for more than 2 weeks, or if it hurts even just to walk, you need an examination. In particular, if one point is intensely painful or there is swelling, a stress fracture is possible, so we recommend coming in right away.
Does shin taping help?
Taping can help with temporary pain relief and support, but it does not address the underlying cause. Correcting ankle-knee alignment issues and landing patterns comes first, and these must be addressed together to reduce recurrence.
What running habits help prevent shin pain?
It is important not to increase your weekly running distance abruptly by more than 10%. Suddenly switching surfaces, such as from concrete to a dirt trail, also calls for caution. Replace running shoes roughly every 500km, and learning to land on the forefoot or midfoot instead of the heel can reduce the impact on your shins.
References
- Moen MH et al. Medial tibial stress syndrome: a critical review. Sports Med. 2009;39(7):523-546. PMID 19530750
- Galbraith RM, Lavallee ME. Medial tibial stress syndrome: conservative treatment options. Curr Rev Musculoskelet Med. 2009;2(3):127-133. PMC2696139
- Hamstra-Wright KL et al. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. Br J Sports Med. 2015;49(6):362-369.
- Reinking MF et al. Medial tibial stress syndrome in active individuals: a systematic review and meta-analysis of risk and prognostic factors. Int J Sports Phys Ther. 2017;12(7):1049-1064. PMC5726289