Shin Splints When You Start Running: Why They Happen and What Helps
That ache along the inside of your shin is one of the most common running injuries, and new runners get it most. What it usually is, when to see a doctor, what helps, and how to come back.
By Just5K
Key Takeaways
- Shin splints usually means an ache along the inner edge of the shin bone, often in both legs, that comes with running. It's one of the most common running injuries.
- It's an overload problem. The bone and the tissues attached to it are being asked to do more than they're ready for, and new runners are the people most likely to ask.
- What helps most is less running for a while, not a gadget. Ice and painkillers can take the edge off, but they don't heal it.
- Some pain is different. Pain in one small spot on the bone, pain at rest or at night, a limp or swelling: see a doctor.
This article explains what's common. It isn't a diagnosis. If something doesn't feel right, get it checked.
Three Weeks In, and Your Shins Hurt
The first runs went fine. Then, a few weeks in, an ache shows up along the front and inside of your lower legs. It's there at the start of a run, sometimes fades as you warm up, and comes back afterwards. Pressing along the bone is tender.
That's the classic picture of shin splints, and the timing is typical too: bone stress problems often show up three to four weeks into a new routine.
What Shin Splints Usually Are
Doctors call it medial tibial stress syndrome. In research it means pain along the lower inner edge of the shin bone that comes with exercise, with tenderness over a stretch of at least 5 centimetres rather than one spot. It's often in both legs.
It used to be blamed on inflammation of the bone's outer layer. The research doesn't support that; the better explanation is overload: the shin bone and the muscles and tissues attached to it are taking more than they've adapted to yet. Your heart and lungs tend to get fitter faster than your bones adapt, which is why you can feel ready for more running while your shins aren't.
Why New Runners Get Them
- They're common. In a review of running injuries, shin splints came out as the most common one. How many runners get them varies a lot between studies, from about 1 in 20 to 1 in 3.
- New runners get hurt more in general. A review of running injury studies found new runners get injured about twice as often per hour of running as experienced ones.
- Known risk factors from two reviews: being female, having had shin splints before, fewer years of running, higher body weight, and feet that roll inward more. The effects are small, and most of them you can't change. What you can change is how much you ask of your legs, and how fast.
You'll often hear the "10% rule" and "avoid hard surfaces" as the fix. The evidence for both is thin: in a trial of 532 new runners, a plan built on adding 10% a week had the same injury rate as a standard one. Softer ground can feel kinder, but it's advice from experience more than from trials.
Is It Shin Splints or Something Else?
| Usually shin splints | Get it checked | |
|---|---|---|
| Where | Along a stretch of the inner edge of the shin, often both legs | One small spot on the bone you can point to with a fingertip |
| When | During and after runs, easing with rest | At rest, at night, or when you walk |
| What else | Maybe mild swelling | A limp, swelling or bruising |
A stress fracture is the main thing to rule out: its pain sits in one spot and keeps going at rest. Mayo Clinic notes that shin pain which becomes constant can mean the bone itself is stressed.
See a doctor sooner if you notice:
- pain in one spot on the bone, pain at night, or pain that makes you limp;
- numbness, tingling, weakness or tightness in the leg during exercise (NHS);
- one leg that's swollen, throbbing and red or darker than the other: get urgent advice (NHS);
- a leg ache when you walk that goes away after a few minutes' rest, coming back each time: worth telling your GP (NHS).
What Helps
Run less for a while. The NHS says to stop the exercise that caused the pain and not rush back to the same level. The American Academy of Orthopaedic Surgeons suggests several weeks off running, swapping in swimming, cycling or an elliptical. In three military trials, rest did as well as any treatment it was compared with.
Keep moving gently. Walking, swimming, cycling and yoga keep the habit going while your shins settle. There's more in what rest days actually do.
Ice and painkillers ease pain, they don't heal. The NHS suggests ice wrapped in a towel for up to 20 minutes every 2 to 3 hours, and paracetamol or ibuprofen if you need it. Check the label or ask a pharmacist. There's no evidence either one makes shin splints heal faster.
Things with little evidence behind them: compression sleeves made no difference in a trial, stretching doesn't seem to prevent running injuries, and braces and taping haven't been shown to work either. A review of treatments couldn't recommend any single one.
How long it takes. The NHS says shin splints usually get better within a few weeks. Cases that have gone on for months take longer: in one trial, athletes who'd had symptoms for about half a year needed three to four months to get back to running.
If it isn't improving, a physiotherapist can look at what's driving it. In one trial in recreational runners, arch-support insoles eased pain sooner, though by 18 weeks there was no difference. A physio can tell you if they're worth a try for you.
Coming Back to Running
- Wait until walking is pain-free. The orthopaedic surgeons suggest two pain-free weeks before running again.
- Come back with walk-run intervals, three times a week with rest days between. One trial's return plan started once walking had been pain-free for two days in a row.
- Let pain set the pace. In that trial, people moved on only while pain stayed low during the run (under 4 out of 10) and was gone by the next day. If it was higher or lingered, they repeated the step with a couple of minutes less running. Nobody has compared this with full rest, but it's a careful way back.
- Go back a few weeks in your plan, not to where you stopped. This Couch to 5K plan, week by week makes it easy to pick a week that feels comfortable, and Couch to 5K too hard? has more on slowing a plan down.
- Run easy. Slow enough to talk, with short, light steps. Speed can come much later.
Can New Running Shoes Cause Shin Splints?
Swapping one normal running shoe for another hasn't been studied for shin splints, and no type of shoe has been shown to prevent injuries. What does carry a risk is switching suddenly to minimalist or barefoot-style shoes: in one trial, injury risk in minimalist shoes rose for runners above about 71 kg. If your shoes are comfortable and not falling apart, they're probably not the problem. More on choosing a pair in running shoes for beginners.
Where Just5K Fits
Full disclosure: this is our app. Just5K builds up in small steps: one-minute jogs between walks to start, three short sessions a week, and a longest run that grows a few minutes at a time. If your shins need a break, set your status to Injured in the app: sessions and reminders pause until the date you pick, and after a week or more away the plan repeats a week so you ease back in.
Just5K is in a free public beta on TestFlight now, and after the App Store release the whole road to your first 5K stays free.
FAQ
How long do shin splints last?
The NHS says they usually get better within a few weeks if you ease off. If you keep running through the pain, they can drag on for months.
Can I run with shin splints?
The NHS, the American Academy of Orthopaedic Surgeons and Mayo Clinic all say to stop the activity that hurts and come back gradually once it's pain-free. Some physios use a careful walk-run return guided by pain, but that's a step back to running, not running through it.
Should I ice shin splints?
You can: the NHS suggests ice wrapped in a towel for up to 20 minutes every 2 to 3 hours. It eases the pain; it hasn't been shown to speed healing.
Are shin splints a stress fracture?
No, but they're related: both come from stress on the bone. A stress fracture tends to hurt in one spot, at rest and at night. If that sounds like you, see a doctor.
Do shin splints mean I shouldn't run?
No. Plenty of runners get them once, back off, and come back stronger. Often it's a sign of a bit too much, a bit too soon.
Your shins will catch up. Back off, keep moving gently, and come back with walk breaks. Just5K's plan waits while you heal, and eases you back in when you return.