Shin splints — medically known as medial tibial stress syndrome (MTSS) — is one of the most common running injuries, causing pain along the inner shin bone. Without proper management, shin splints can progress to a stress fracture. Physiotherapy at Burwood Physio provides accurate diagnosis, load management, and a structured return-to-running programme.
What Are Shin Splints?
Medial tibial stress syndrome refers to pain along the posteromedial border (inner edge) of the tibia, caused by excessive stress on the tibial bone and its periosteum. It represents a stress reaction — the bone is being loaded beyond its current capacity to adapt. MTSS accounts for approximately 15% of all running injuries and is most common in runners, military recruits, and dancers who rapidly increase training volume.
Symptoms of Shin Splints
- Diffuse pain along the inner shin — typically the lower two-thirds of the tibial shaft
- Pain worse at the start of a run, may ease during running, but returns afterwards
- Tenderness along a broad stretch of the inner shin (greater than 5cm)
- Morning stiffness and shin aching after exercise
- Progressive worsening if training continues unchanged
Shin Splints vs Stress Fracture
A tibial stress fracture causes pinpoint tenderness at a specific spot, pain that worsens progressively through a run forcing you to stop, and pain with percussion testing. If a stress fracture is suspected, your physiotherapist will refer for MRI to confirm — stress fractures require 6–8 weeks of protected loading, not the same management as MTSS.
Causes and Risk Factors
- Training load errors — “too much, too soon” — the most common cause
- Transition to harder surfaces or return after a break
- Poor or worn footwear
- Foot overpronation — increases tibial torsional loading
- Hip and calf weakness — reduces shock absorption
- Low bone density in female athletes (relative energy deficiency in sport)
Physiotherapy Treatment at Burwood Physio
Load Management
Reducing running volume to a pain-free level is the first step. A general guideline: reduce by 50% then progressively increase by 10% per week as symptoms allow. Cross-training with swimming, cycling, or aqua jogging maintains fitness during recovery.
Strengthening
Calf strengthening (gastrocnemius and soleus), hip abductor strengthening, and tibialis posterior loading progressively build capacity to handle running load. These exercises address the underlying muscular deficits that allow MTSS to develop.
Running Technique and Footwear Review
Your physiotherapist will assess your running gait and provide cues to reduce tibial loading — typically by increasing step rate and reducing overstriding. Footwear assessment and, where indicated, temporary orthotic use can reduce pronation-related tibial stress.
Return to Running Programme
A structured graded return starting with walk-run intervals, progressively reducing walking, safely reintroduces running load. Monitoring with a symptom rating scale (pain during and after runs) guides progression.
How Long Does Recovery Take?
Mild MTSS typically resolves within 4–6 weeks. Moderate to severe cases may require 8–12 weeks before full return to running. Trying to push through shin splints without managing load leads to progression to stress fracture, which requires months of recovery.
Book a Shin Splints Assessment at Burwood Physio
Get shin pain assessed early — before it becomes a stress fracture. Located at Shop 2, 36-38 Victoria St E, Burwood NSW 2134. HICAPS on-site, all health funds accepted. Serving runners from Burwood, Strathfield, Concord, and the inner west.
Call 02 8322 9022 or book online.