My Shins Hurt When Running
Inner shin pain while running is most often medial tibial stress syndrome (MTSS). Commonly called ‘shin splints,’ it’s an overuse injury.
What Is MTSS (Shin Splints)?
A condition where repetitive stress accumulates in the muscles and periosteum (bone membrane) attached to the inner tibia, causing inflammation.
Location
Mainly occurs in the lower 2/3 of the inner tibia. Pain is felt over a wide area, at least 5cm long.
Involved Muscles
Posterior tibialis, flexor digitorum longus, soleus attach to the tibia, and repetitive pulling creates the problem.
Do You Have These Symptoms?
Inner Shin Pain
Dull pain along the inner edge of the shinbone. Not a single point, but a wide area.
Pain at Exercise Start
Hurts when starting to run, may decrease as you warm up. Returns after exercise.
Tender to Touch
Tenderness when pressing along the inner shin. Multiple spots along the bone may hurt.
Morning Stiffness
Shins may feel stiff and uncomfortable when taking first steps in the morning.
Difference from Stress Fracture
MTSS causes wide area pain, but stress fracture causes severe pain at a single point. If pain persists with rest or one spot is extremely painful, suspect stress fracture.
What Causes It?
Sudden Training Increase
Suddenly increased running distance, frequency, or intensity (especially beginners)
Excessive Foot Pronation
Flat feet or overpronation running pattern where foot rolls inward excessively
Calf Muscle Weakness/Tightness
Weak calf muscles or lack of flexibility
Hard Surfaces
Repetitive running on concrete, asphalt, or other hard surfaces
Inappropriate Shoes
Running shoes with worn cushioning, shoes not suited to foot type
How Is It Treated?
Ignoring MTSS and continuing to run can progress to stress fracture. Early aggressive treatment is important.
Key: Must treat hip (pelvis) muscles together
Treating only the shins leads to recurrence. Weak glutes (hip muscles) cause pelvic instability, and that impact transmits to the shins. Treating shins and pelvis together is effective.
Treatment Goals
1. Reduce inflammation and tension around shins
2. Restore calf muscle flexibility and strength
3. Strengthen glutes (hip muscles), restore pelvic stability ← Key
4. Correct biomechanical issues in foot and leg
Resolve MTSS with Circulation Treatment
We treat shins + pelvis (hip) together
- Circulation HD: Reduce inflammation in shin, calf, and glute fascia; release muscle tension
- Circulation PT: Calf stretching, glute strengthening, restore pelvic stability, correct running form
Self-Care Tips
Adequate Rest
Stop running when in pain. Substitute with low-impact activities like swimming or cycling.
Calf Stretching
Gently stretch calf muscles (gastrocnemius, soleus). Recommended 2-3 times daily.
Warm Compress
Apply 15-20 minute warm compress to shins after exercise. Promotes blood circulation and relieves muscle tension.
Check Running Shoes
Ensure adequate cushioning and proper fit for foot type. Replace every 500-800km.
When to See a Doctor?
• Pain persists after 2 weeks of rest
• Single point is very painful or swollen (suspect stress fracture)
• Hurts even when walking
• Pain is progressively worsening