That diffuse ache along the inner edge of the shin, worse at the start of a run and after you stop, is the classic picture of shin splints, or medial tibial stress syndrome. It is one of the most common running complaints, and almost always a signal that load has climbed faster than the tissue could adapt to it.
Running pain that settles at the knee instead is covered in PhysioHub's guide to knee pain when running.
Shin splints describe an overload of the tissue and bone along the inner shin where the calf muscles attach. Do too much too soon, whether that is mileage, pace, hills or a switch to harder surfaces, and that tissue gets irritated before it has had time to strengthen. It is a capacity problem: the demand outpaced the adaptation. The NHS page on shin splints gives a clear symptom overview.
This distinction matters. Shin splints usually cause pain spread along a stretch of the shin that eases as you warm up. A bone stress injury or stress fracture tends to be a sharp, pinpoint pain over one small spot that worsens the longer you run and can hurt at rest or at night. Pinpoint, worsening or night pain deserves an assessment before you run through it.
Our guide to injury prevention exercises covers the strength work that keeps the lower leg resilient.
The shin pain arriving in the first half of the year is nearly always the same story: a couch-to-5k plan started in January, a mileage jump in spring, and shins that flare on the third or fourth run of every restart. Alex runs the clinic's return-to-running work on graded loading for that reason, having spent a career in sport learning what a jump in the training week costs.
The distinction that matters most is between medial tibial stress syndrome, the classic shin splints, and a bone stress injury. They look similar early on and are managed very differently, because one tolerates a carefully graded return while the other needs load taken off the bone first. Diffuse pain spread along the inner shin border points one way; a focal tender spot that hurts on hopping points the other. Getting that wrong and continuing to run through it is how a manageable few weeks turns into a stress fracture and a season.
Our sports injuries and performance service separates those two before any return-to-running plan gets written.
Can I keep running through them?
Often you can run at a reduced load, provided the pain stays low and settles quickly. Pain that climbs during a run or lingers afterward means you have done too much.
Will new trainers fix it?
Footwear can help at the margins, but shin splints are mostly a load and strength issue. Address those and the shoes matter far less.
PhysioHub – Empowerment through Evidence-Based Education.
Every body is different. Book a thorough assessment and get advice that is specific to you and your goals.
Book an Appointment