How to Treat Shin Splints: A Physiotherapist’s Guide for Runners

Shin splints – known medically as medial tibial stress syndrome – are a frustrating injury that many runners face. That persistent ache or sting down the inside of your shin often flares up during or after a run, and if ignored, it can put your training on hold for weeks. In fact, research shows that shin splints affect around 13.6% to 20% of runners. This highlights just how common and impactful this injury can be.

With the right approach, though, shin splints do not have to derail your progress.

What are shin splints, and what do they feel like?

Shin splints happen when the muscles and tissues around your shinbone are repeatedly overloaded. Over time, this leads to inflammation, irritation, and pain along the inside of your lower leg.

How do you know if you have shin splints?   

Typical symptoms include:

• A dull, aching or sometimes sharp pain in the inner part of your shin
• Discomfort that sets in during or after running
• Tenderness when pressing along the lower third of your shin
• Pain that feels worse the more you train – or lingers even after a session
• Often, both legs are affected, but one may hurt more than the other

Sometimes, the pain persists during everyday activities, such as walking, going upstairs, or even just standing.

Because shin splints can feel similar to other conditions (like stress fractures or compartment syndrome), it is crucial to have your symptoms properly assessed by a physiotherapist.

Understanding the cause  

Shin splints are an overuse injury, and they do not usually show up overnight. They often build up over time when your training outpaces your body’s ability to recover. Contributing factors include:

• Suddenly increasing your mileage, pace, or number of training days
• Running with poor mechanics or posture
• Weakness in your calves, hips, or core muscles
• Running on hard, sloped, or uneven surfaces
• Foot biomechanics that reduce shock absorption

Does rest help?

Short-term rest can relieve pain, but it does not fix the problem. Without addressing the cause, the pain is likely to return when you resume training. That is why rest alone is not enough and why a personalised rehabilitation plan is so important.

We use active treatment strategies to reduce your pain and help your body recover while continuing to move safely.

Step 1: Manage pain and load   

The first step is to ease the strain on your shins, but keep you moving. Depending on your condition, your physiotherapist may recommend:

• Reducing your running volume temporarily or swapping in low-impact training like swimming or cycling
• Manual therapy or soft tissue release to relieve tightness and improve circulation
• Joint mobilisation to restore movement in the ankle and foot

These techniques help calm the symptoms and support the healing process while maintaining strength, flexibility, and cardiovascular fitness.

Step 2: Strengthen the kinetic chain  

Pain in your shin does not always start in your shin. Often, the issue lies elsewhere, like in your hips, calves, or core. That is why rehab must go beyond treating the site of pain.

We will design a strengthening programme that focuses on:

• Calf and foot muscles
• Hip stability and glute activation
• Core control for better posture and endurance
• Balance and single-leg coordination

As you improve, your exercises will progress to match your recovery and running goals. These include resistance band drills, isometric calf exercises, single-leg stability exercises, and functional strength movements.

Step 3: Return-to-running

Once your symptoms have settled and your strength has returned, it is time to get back to running – but with a plan. At this stage, your physiotherapist may refer you to a biokineticist who will:

• Assess your running gait
• Design a graded return-to-running programme
• Help you rebuild strength and prevent future overload

This collaborative handover ensures that you are not only pain-free but also ready to train with confidence.

We will help you to put your best foot forward! Click here to schedule an appointment with one of our physiotherapists in Cape Town.