Finding yourself hobbled with shin pain a few weeks after starting a running routine can suck the excitement out of a new fitness program. But there’s good news: You can take steps to prevent shin splints, a common overuse injury frequently seen in people who are new to high-impact activities like running.
Some people use shin splints as a general way of describing any type of pain in the lower leg. Most often, however, they’re referring to what health care providers call medial tibial stress syndrome, an irritation of your shinbone’s periosteum, the tissue surrounding bones that provides blood supply, Rich Willy, PT, PhD, an associate professor at the University of Montana and director of the Montana Running Lab, tells SELF.
Symptoms of shin splints include an achy pain that’s widespread throughout the inside of one or both lower legs during a run or workout but typically subsides as you keep going or soon afterward, Brittany Moran, DC, CSCS, a certified running coach for Nike Toronto, sports chiropractor, and elite marathoner, tells SELF.
And pain is never something to take lightly: If you don’t take steps to address the problem, running through shin splints can cause the pain to worsen until it prevents you from running at all. What’s more, a more serious injury like a stress fracture—a tiny crack in your bone that requires rest to heal—can develop too. That’s why proper identification of the problem is so important.
Fortunately, though, there are things you can do both to prevent shin splints from occurring in the first place. But before we get into all that, let’s dive into what exactly is going on in your lower legs that’s causing that discomfort in the first place.
What are shin splints?
Shin splints are an overuse injury, meaning they’re the result of small, repetitive strain rather than a sudden accident or trauma. Though they’re especially common in runners, shin splints can also occur in dancers, hikers, and soccer players, or anyone else doing high-impact movements.
Before we dive in, it’ll be easier to discuss shin splints if we can do a quick anatomy lesson. There are two bones in your lower leg: the larger tibia, which is in the front of your leg, and the smaller fibula, which is located on the outside of your tibia. You feel shin splint pain on your tibia, due to the irritation of the bone tissue called periosteum, which acts as a sheath that covers your tibia.
Though you’ll likely feel the pain on the inside of your lower leg, the problem often begins closer to the front of your foot, Efren Caballes, DO, a sports medicine physician and cohost of the Ready to Run podcast, tells SELF. Many runners—especially those whose bodies are still getting used to the mechanics of running—have some wobbling in the front of their foot as they move through their stride. This lack of control causes your arch to collapse a bit as you roll through your foot, then push off for your next step.
To compensate, your posterior tibial tendon, which is the thick band of tissue that attaches your calf muscles to the bones of your foot, begins working overtime to stabilize your ankle. The tendon then pulls harder on the bone. That extra strain and traction causes swelling and pain in your periosteum, Dr. Caballes says.
Why do I get shin splints so easily?
A predilection for shin splints can occur due to your training, your gear, something more intrinsic about the way you move or are built—or a combination of several of these factors. Knowing what’s involved in their development can play key roles in prevention:
- Overuse: Shin splints are an overuse injury; they occur when you increase the demands on your musculoskeletal system faster than your body can adapt to meet them. This can happen when you’re new to your activity, ramping up the amount or intensity of your training, or making another abrupt change (for instance, suddenly running all your miles on much harder terrain than you’re used to). Your leg muscles, especially in your calves, might not yet be strong enough to absorb the shock from the increased amount of pounding, Moran says.
- Break from training: Returning to high-impact activities after time off also increases your risk. For instance, postpartum runners getting back into the sport after childbirth may develop shin splints even if they’ve never had them before, Dr. Caballes says.
- Inherent muscle and stride factors: Runners with flat feet, whose arches have already collapsed, may also be more predisposed. People with weak or unstable hips may also be at greater risk, since that can cause increased stress on the shin as their feet land across the midline of their body with their strides, Moran says. There’s also research linking a slower cadence, or number of steps per minute, to shin splints.
- Worn-out shoes: Running shoes are commonly blamed for shin splints, but they’re rarely the sole cause of these or other running injuries, Moran says. Still, it’s possible that worn-out shoes could transfer more force up into your leg, contributing to your pain, she says.
- Change in shoe style: Switching from shoes with a high drop—the difference between how much foam sits under your heel and how much is under your toe—to a lower drop could amplify the strain on your shins, Moran says.
What are the best ways to prevent shin splints?
Your calves are key here. The stronger your calf muscles, the better your body can absorb and appropriately distribute the forces from the ground through your entire body, or kinetic chain.
“If you’re looking to start a running program, one of the best things you can do for the month to six weeks beforehand is to start doing some calf raises,” Dr. Willy says. “That will make your muscles stronger, and also condition the bone underneath,” increasing your resistance to both shin splints and stress fractures. Add in calf raises if you’re already running too—and a dedicated calf workout to really give them some attention won’t hurt, either.
Additionally, core and hip-stabilizing exercises improve your running alignment, and can help prevent the drop in your hips that can contribute to shin splints, Moran says. Simply practicing standing on one foot can help, she says. But you’ll also want to really target:
- Your butt muscles, including your gluteus medius—a small muscle along the side of your butt. A great exercise to try is star toe touch. This workout also hits those small, stabilizing butt muscles.
- All the muscles in your core, including your transverse abdominals (your deepest abdominal muscles) and obliques (the muscles on the sides of your trunk). Look to include moves like the plank and side plank. After you’ve mastered those, incorporate more complex single-leg movements, like single-leg deadlifts, lunges, and suitcase carries, which require you to fire your core to keep your body steady.
- Your hip flexors, through exercises like the banded marches and lunges.
Avoid rapidly ramping up the amount of time or distance you’re running or doing any other high-impact activity. Running coaches have long used the 10% rule, which means not increasing your total mileage by more than 10% each week. But what represents too much too soon for any single person depends on a wide variety of factors, from your experience level to your gait pattern to what’s going on in the rest of your life.
Following training plans from credentialed coaches or credible sources, which build slowly over time, can help. But it’s also a good idea to listen to your body and go more slowly if you start to feel pain.
If you’re the type of runner who tends to train for one or two big races per year, try to keep some running in your schedule even when you’re not officially on a training program, Dr. Caballes says. That way, your bones and muscles will be better able to withstand the added strain when you begin increasing your mileage.
Dr. Caballes recommends runners work on better controlling the muscles in their feet. Working on this skill for as little as 5 to 10 minutes per day, a few days a week, makes a big difference, he says. In his clinic, he uses a wobbly tool called a MOBO mobility board ($90, amazon.com) and has runners do exercises like the banded foot twist, where you anchor a resistance band to a wall or door, stand on the wobbly board on one leg, and twist your torso while holding the other end of the band.
But even without that specific board, you can do exercises like the pass around, where you stand on one foot and transfer a kettlebell, dumbbell, or heavy object like a milk jug from one hand to the other.
Rather than recommending specific stretches to prevent shin splints, Moran and Dr. Caballes advise focusing on mobility or how well your ankle is moving. Ankle mobility matters with shin splints, since the better the joint moves through its full range of motion, the less likely the tendon is to work overtime and pull on the periosteum.
Here’s how you can check your ankle mobility:
- Stand, barefoot, with one foot about 1.5 to 2 inches away from a wall.
- Push your knee forward and see if you can touch it to the wall without lifting your heel off the ground. If so, you’re good!
- If not, do a few repetitions of the same movement regularly to work toward increasing that range of motion.
- Better yet, move your ankle in circles or trace letters with your toes while you’re sitting at your desk, to improve your mobility, Moran says. Ideally, you’d do a little bit of this every day, but three to five days per week is better than none, she says.
Prioritizing eating before and after your workouts is important, whether you’re a new runner just getting started or are already logging heavy mileage. When you’re running or training heavily, not eating enough to fuel your workouts can lead to a state called low energy availability and, eventually, a condition called relative energy deficiency in sport (RED-S). This increases your risk of any type of injury, especially those involving bones, Moran says. Prioritize eating before and after workouts, but make sure you’re getting enough energy throughout the day too. Taking in foods rich in calcium and vitamin D can also be helpful for those at risk of bone injury, according to the Canadian Family Physician journal.
Whether the pressure you’re under comes from a training plan, a fight with your partner, or layoff threats at work, too much stress can increase your injury risk.
“Your brain does not care—stress is stress is stress, and it can only take so much,” Moran says.
Though you can’t always escape stressful situations, you can build your coping skills and be extra mindful about other injury prevention steps when life is otherwise overwhelming. Knowing when to back off your workout routine is crucial too. If exercise is a main form of self-care for you, finding chill ways to check that box can give your mind the release it needs while protecting your body from too much impact—and shin splints from developing along with it.
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