03/12/2025
SHIN SPLINTS REHAB (Medial Tibial Stress Syndrome)
I’ve seen (and rehabbed) a lot of shin pain over the years.
The patterns are pretty consistent, even though the fix is never identical.
Here’s, from my experience, what tends to help.
First, you have to manage the load.
For most runners, the aggravating factor is running itself. That doesn’t automatically mean stopping all together, but it does mean pulling volume and or intensity back to a level your legs can tolerate without flaring things up. ( depending on severity and presentation full rest and cross training alternatives might be best )
Then you rebuild capacity, properly.
That’s progressive loading through the lower leg using isometrics / isotonics etc. Early on, flexed ankle (dorsiflexed ), knee over toe positions can feel grumpy, if so start more neutral and earn those ranges over time.
One big mistake I see is not zooming out with the rehab.
Just because the pain is in the shin doesn’t mean tib raises are the answer. The shin bone ( tibia ), and its thin out layer of bone (periosteum) is reacting to excessive load coming from that area. There’s many factors to how we distribute load through our leg but building strength throughout our soleus, quads, glutes etc all play their role in propulsion / store and releasing energy.
Another common issue is skipping rehab steps.
Pain settling is not the same as being ready. Too many runners go from basic calf / leg work straight back to running and miss the later-stage rehab process . This is where plyometrics come in. Progress them just the same as your strength work. Gradual , over time.
And finally, running needs to come back gradually.
No 0 to 100. Run-walks, controlled progressions, and patience. Manage your pace, avoid gradients to begin with and build both extremely slowly.
As I say often, there is no one size fits all. What works depends on your history, your training load, and where your current capacity sits.
If you want help figuring out what your return to running should look like,
comment ‘SHINPAIN’
and I’ll send you more info about working with me 1:1.