By Jeff Stewart – Podiatrist (B.Pod La Trobe, M.A.Pod.A NSW) | Manly Cove Podiatry
Shin splints are one of the most common complaints I see in runners and active patients on the Northern Beaches. The pain is usually described the same way: a dull, aching soreness along the inner shin that starts during a run, gets worse as the session goes on, and leaves the lower leg feeling tender and heavy afterwards. It is the kind of pain that makes you cut training short – and if you push through it, it has a habit of getting significantly worse.
The frustrating thing about shin splints is that rest alone rarely solves the problem. The pain eases when you stop, but the moment you ramp back up – whether that is running the Manly to Spit, doing laps at Dee Why beach, or getting back into surf club training at Freshwater – it returns. That pattern is a strong signal that something in the underlying mechanics needs to be addressed, not just rested.
What Are Shin Splints?
So What Exactly Are Shin Splints?
Shin splints is the common name for pain along the inner edge of the shin bone. The clinical term is medial tibial stress syndrome, or MTSS – but shin splints is the term most patients know and use, and it describes the condition well enough for most purposes.
The pain comes from the tibial bone and the surrounding tissue being placed under more load than they can comfortably handle. Repetitive impact – running, jumping, high-volume walking on hard surfaces – causes micro-stress to build up in the bone and the muscles that attach to it. When the tissue does not get enough recovery time between sessions, that stress accumulates and becomes painful. In early stages this is sometimes called a tibial stress reaction – a warning sign that if load is not managed, shin splints will follow.
Shin splints stretches – particularly for the calf and tibialis posterior – are often recommended as part of self-management, and they do help with symptoms. But stretching alone does not address the mechanics driving the overload. That is where a proper assessment makes the difference.
Shin Splints vs Stress Fracture – How to Tell the Difference
This is one of the most important distinctions to get right, and one I take seriously with every patient who presents with shin pain. Shin splints and a tibial stress fracture can feel similar, but they are very different conditions with very different management.
- Shin splints typically cause a diffuse ache along a broader stretch of the inner shin, worse during activity and easing with rest
- A stress fracture usually causes a more localised, pinpoint tenderness at a specific spot on the bone, and pain that may persist even at rest or with normal walking
If the pain is sharp, specific, and not settling with a few days of rest, get it properly assessed before running on it again. Running through a stress fracture significantly worsens the injury and can result in a complete fracture. This is exactly the kind of assessment a sports podiatrist is trained to carry out.
Why Do Shin Splints Keep Coming Back?
Rest Is Not a Fix – It Is Just a Pause
The most common pattern I see is a runner who takes two weeks off, feels better, goes back to training, and has shin splints again within a fortnight. This happens because rest reduces the inflammation and pain, but does nothing about the underlying mechanics that caused the overload in the first place.
If you are asking why do my shins hurt when I run, the answer is almost always load – specifically, more load being placed on the tibia than the bone and surrounding tissue can absorb. Shin splints not getting better with rest – or returning every time you increase training load – is almost always a sign that something biomechanical is driving the problem. The common contributing factors include:
- Training load increases: too much, too soon is the single most common cause – ramping up mileage, adding speed work, or starting a new sport season without adequate build-up
- Foot mechanics: overpronation (the foot rolling inward excessively) changes how the tibial muscles absorb load, increasing stress on the shin bone
- Calf and hip weakness: when the calf, glutes, and hip stabilisers are not strong enough to absorb impact properly, the tibia takes more of the load
- Running surface: hard surfaces like concrete and asphalt increase tibial stress – a relevant factor on the Northern Beaches where most running is done on roads, coastal paths, and hard sand
- Footwear: worn-out running shoes or footwear that does not suit your foot type reduces shock absorption and increases load on the shin
Shin Splints Treatment in Manly: What a Podiatrist Can Do
Getting to the Root Cause First
When a patient comes to me with shin pain, the first step is always a proper biomechanical assessment. That means looking at your foot structure, ankle range of motion, calf flexibility, running gait, and the loading patterns that are stressing the tibia. Without understanding what is driving the overload, any treatment is just managing symptoms.
Because my focus is biomechanics and sports injuries, I approach shin splints as a mechanical problem first – not just an inflammation problem that needs rest and ice.
Treatment Options for Shin Splints
Treatment depends on what we find in the assessment, but commonly includes:
- Load management: a structured return-to-running plan that reduces tibial stress while maintaining fitness – not just ‘stop running’
- Gait retraining: addressing the specific running mechanics contributing to shin overload, such as overpronation or excessive heel striking
- Strengthening program: targeted calf, tibialis posterior, and hip strengthening to improve shock absorption and reduce tibial load
- Orthotics for shin splints: a common question is do I need orthotics for shin splints – the answer depends on your foot mechanics. Where overpronation or poor foot function is contributing, custom or practitioner-grade prefab orthotics can significantly reduce the tibial stress driving the pain
- Footwear assessment: matching the right shoe to your foot type and running style makes a measurable difference – we often find patients are in completely the wrong shoe for their mechanics
- Shockwave therapy: for persistent cases that are not responding to conservative treatment, shockwave therapy can accelerate tissue healing and reduce chronic pain – we offer this at Manly Cove Podiatry
When to See a Podiatrist for Shin Pain
It is worth booking an assessment if:
- Shin pain has been going on for more than 2 to 3 weeks
- The pain returns every time you get back to training
- You have sharp, localised pain at a specific point on the shin bone
- The pain is present during normal walking or at rest
- You have tried rest and stretching but nothing is sticking
How Long Do Shin Splints Take to Heal?
It Depends on What Is Driving Them
For patients who come in early and follow the treatment plan consistently, significant improvement is usually seen within 4 to 6 weeks. Cases that have been grinding on for months – where the tibial stress has built up considerably – take longer to fully resolve, though pain levels typically improve within the first few weeks of addressing the underlying mechanics.
The most important thing I tell runners with shin splints is this: do not measure recovery by pain alone. The tibia continues to remodel and strengthen for weeks after the pain settles. Returning to full training too quickly – before the bone has fully adapted – is the most common reason shin splints keep coming back. We will give you guidance on an expected recovery timeframe for your specific situation at your appointment.
At Manly Cove Podiatry, we see shin splints regularly in runners and active patients across Manly, Balgowlah, Freshwater, Dee Why, and the wider Northern Beaches. If shin pain is keeping you off the tracks, the coastal paths, or the surf club circuit, do not wait for it to sort itself out. A proper biomechanical assessment will tell you exactly what is driving the problem and what needs to change to fix it properly.
Book a shin splints assessment at Manly Cove Podiatry
Phone: (02) 8966 9552
Address: Suite 12, 35-36 East Esplanade, Manly NSW 2095
Hours: Monday to Friday 8am-6pm, Saturday 8am-12pm
Saturday appointments available – no referral needed
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