Ankle & Foot
Shin Splints (Medial Tibial Stress Syndrome)
Also called: MTSS
Diffuse aching along the inner shin from bone-level overload — the classic 'too much, too soon' injury of new runners, returning athletes, and military recruits. Sits on a spectrum with stress fracture, which is why the pattern (diffuse vs. pinpoint) matters.
Common signs
- Aching along several centimeters of the inner shin
- Hurts at the start of running, may ease, aches after
- Tender along a broad stretch of bone edge
- Both legs commonly involved
Seek help now if
- Pinpoint one-spot bone pain, pain with hopping, or night bone ache — stress fracture until proven otherwise
- Pain with swelling, tightness, and numbness during exertion that resolves with rest (consider compartment syndrome)
- Pain at rest progressing
Any of these: call 911 or get to an emergency room first. Everything else can wait.
What to do first
- Cut running volume below the symptom threshold — often 50% — and keep pain ≤3/10 during and after
- Check the calendar: mileage spikes, new surfaces, worn shoes explain most cases
- Begin calf/foot strengthening and hip work; consider gait review
If it's become chronic
- Rebuild with the 10% rule and pain-guided progression over 4–8+ weeks
- Recurrent cases: assess bone-health factors (energy availability, vitamin D, calcium — especially in female athletes with cycle irregularity)
- Not improving with genuine load management → image for stress fracture
Natural healing options we use
- Load management and graded return programming
- Manual therapy for calf complex; chiropractic care for foot/ankle/hip mechanics
- Attended e-stim for symptom relief
- Bone nutrition: calcium, vitamin D, adequate energy intake
About imaging
Clinical initially; MRI when stress fracture is suspected (X-rays are late to show it).
Daily self-care
- Run every-other-day during rebuild
- Calf raises and foot-core work daily
- Replace shoes on mileage, not appearance
How we can help
More in Ankle & Foot
Lateral Ankle SprainHigh Ankle SprainAchilles TendinopathyAchilles Tendon RupturePlantar FasciitisPosterior Tibial Tendon DysfunctionBone Stress Injury / Stress FractureMorton's Neuroma
Please read: this page is education, not a diagnosis. A proper examination is how a condition gets confirmed and a plan gets built. See our medical disclaimer.