FAQs: Shin splints (Medial Tibial Stress Syndrome)

Finn Diamond 01/07/26

What is Medial Tibial Stress Syndrome? Medial Tibial Stress Syndrome (MTSS), commonly known as shin splints, is an overuse injury that causes pain along the inner border of the tibia (shin bone). It typically develops when repetitive loading exceeds the body’s ability to adapt, leading to irritation of the bone and surrounding tissues.

It is thought to involve irritation of the periosteum (the outer lining of the bone) due to repeated pulling from muscles and fascia on the inner aspect of the shin.

What causes shin splints? Shin splints are usually caused by a sudden increase in training load or intensity. Common contributing factors include:

• Increased running volume

• High-impact activities

• Poor footwear

• Hard training surfaces

• Reduced calf strength

• Limited ankle mobility

How is it different from a stress fracture? One of the biggest concerns people have when experiencing medial shin pain is whether it could be a stress fracture. While both conditions can feel similar, there are some key differences.

Shin splints:

• Pain is usually more diffuse and spread out along the tibia

• Tenderness will be on the muscles medially and not always directly on the bone

• Symptoms may warm up with movement

• There should be no pain at rest

Stress fracture:

• Pain is typically very specific to one spot

• Tenderness is directly over the bone

• Pain is present with loading and often during walking

• Symptoms generally do not warm up and remain constant even a dull ache at rest

It is important to understand that shin pain exists on a continuum and does not always jump from shin splints to a stress fracture. Stress reactions within the bone can occur first and, if not managed appropriately, may progress to a stress fracture.

If you are unsure about your symptoms, come see someone on our team for advice to better understand where you sit on this continuum.

How long does it take to recover? Recovery timeframes can vary significantly depending on severity. Mild cases may settle within 3–5 weeks, while more persistent cases can take 8–12 weeks or longer.

Should I stop running? Not always. Some people may need to temporarily reduce their running load, while others may be able to continue running normally with modification. Simple modifications that may help settle your symptoms:

• Decrease your weekly kilometers.

• Reduce the pace you are running.

• Change the environment (example: run on a field or treadmill)

Can I still go to the gym? Yes. Maintaining general lower limb strength is very important, particularly through your calves, tibialis posterior and intrinsic foot muscles. If you are not doing weighted calf raises and you are a runner then start by adding both a seated and straight leg calf exercise into your routine. If you need more guidance around exercise prescription then come see someone on our team at Limbr.

When can I return to sport? Return to sport varies from person to person. Some athletes may need a period of load management, while others may be able to continue participating normally alongside education, mobility work and strengthening rehabilitation.

Some strategies that may help reduce symptoms include:

• Compression around the calf to assist with muscle support

• Soft tissue release or self massage before activity

• Taping techniques to support the muscles around the shin

• Better footwear

Final thoughts: MTSS is a very manageable condition with the right combination of education, load management, stretching and strengthening, and hands-on treatment. When identified early, symptoms can often settle relatively quickly. However, if your shin pain is persisting, worsening, or you are unsure how to manage it, book in with one of our osteopaths or physiotherapists at Limbr Health.