Shin Splints: Why Your Shins Hurt When You Run

By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published October 2026

You started running again, signed up for a race, or joined a new boot camp class. A few weeks in, there's an ache along the inside of your shins that shows up during your runs and lingers afterward. Some days it's sore just walking down the stairs.

Shin splints are one of the most common overuse injuries in runners and active people. The good news is that most people recover fully with the right changes. This article explains what shin splints are, why they happen, how they differ from a stress fracture, and how to keep running safely.

The short answer

"Shin splints," known medically as medial tibial stress syndrome, describes exercise-related pain along the inner edge of the shinbone. It usually develops after a sudden increase in running or training, and it sits at the mild end of a range of bone stress injuries (StatPearls). The cornerstone of treatment is changing your training load: reducing the activity that provokes pain, then building back gradually. Pain in one small spot on the bone, or pain at rest, can mean a stress fracture and needs a medical evaluation. In California, you can see a physical therapist without a referral.

What are shin splints?

Shin splints refers to pain along the lower, inner border of the tibia (shinbone). It's thought to come from repeated stress on the bone and the muscles and tissues that attach to it, more than the leg can recover from between workouts (StatPearls).

Typical features include:

• An ache along the inner edge of the shin, often in both legs
• Tenderness spread over a longer stretch of the bone, rather than one spot
• Pain that starts during or after exercise and improves with rest
• Mild swelling in some people

Cramping, burning pain, numbness, or tingling in the lower leg point to other problems and should be checked by a clinician.

Why do my shins hurt when I run?

Bone, like muscle, adapts to load, but it needs time. Shin splints often show up when training increases faster than the leg can adapt. Commonly reported risk factors include (StatPearls):

• A sudden jump in training, such as more miles, more days per week, or faster runs
• A previous episode of shin splints
• Foot and ankle factors, such as a large drop in the arch or limited ankle bending
• Limited hip rotation
• Higher body weight
• Footwear that doesn't support you well
• Low vitamin D, which your physician can check

Shin splints are more common in women and in people new to running or returning after time off.

Shin splints or stress fracture?

This is the most important question to answer. Shin splints and stress fractures are on the same spectrum of bone stress injury, and shin splints can progress to a stress fracture if training isn't adjusted (StatPearls).

Some general differences:

• Shin splints: tenderness spread along a longer section of the inner shin, typically more than about 5 centimeters (2 inches)
• Stress fracture: sharp, pinpoint tenderness in one small spot on the bone

See a physician promptly if you have:

• Pinpoint pain on the shinbone
• Pain at rest or at night
• Pain that's getting worse even after cutting back
• Pain when hopping on the injured leg
• Swelling or a bump on the bone
• Numbness, tingling, cramping, or burning in the lower leg
• A history of stress fractures, irregular periods, or low bone density

X-rays are often normal early on, so your physician may order an MRI to tell the difference. Imaging decisions are made by your physician.

How can I keep running?

Activity modification is the cornerstone of treatment (StatPearls). That usually means:

• Cut back, don't necessarily stop. Reduce the running or jumping that brings on pain, and keep your fitness with lower-impact options like cycling, swimming, or the elliptical.
• Return gradually. Many clinicians wait until walking is pain-free and bone tenderness has settled, then build running back slowly, often adding about 10% per week (StatPearls).
• Use pain as a guide. If pain returns at rest, drop back to the last level that felt fine.
• Look at your shoes. Supportive footwear, and arch-support insoles for some people, may help (StatPearls).
• Build strength. Calf, foot, and hip strength help your legs handle running load.
• Change one thing at a time. Avoid adding mileage, speed, and hills all in the same week.

Research reviews have found that stretching alone, strengthening alone, and compression stockings didn't clearly speed recovery, which is why load management is the foundation of care (StatPearls).

How can physical therapy help?

A physical therapy evaluation may include:

• Your training history, recent changes, and goals
• Where exactly the shin is tender, and screening for signs of a stress fracture
• Calf, foot, and hip strength and ankle motion
• How you walk, hop, and run, and your footwear
• Screening for signs that need a physician's evaluation

A typical plan may include:

• A clear plan for cutting back and cross-training
• Strengthening for the calf, foot, and hips, progressed over time
• A step-by-step return-to-running schedule
• Running form and footwear guidance
• A home program you can keep doing on your own

Physical therapy doesn't guarantee a specific result or timeline, but full recovery is expected for most people with proper management (StatPearls).

At Nova Physical Therapy in North Hollywood, sports injury rehab is one of our core services, and every plan starts with an evaluation so treatment fits what we find.

We screen for warning signs during every evaluation and refer you to a physician when findings call for medical assessment.

Do I need a referral for physical therapy in California?

Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.

Frequently asked questions

How long do shin splints take to heal?
It varies. Many people improve over a few weeks with the right changes to training, while others take longer. Returning too quickly is the most common reason they come back.

Can I run with shin splints?
Sometimes, at a reduced level that doesn't make pain worse. If pain is present at rest or in one small spot on the bone, stop and get checked for a stress fracture.

Should I ice shin splints?
Ice can ease soreness after activity, but it doesn't replace changing your training load.

Do compression socks help shin splints?
Research hasn't shown compression stockings to help shin splints recover faster. Load management and gradual return are more important.

Are shin splints caused by flat feet?
A large drop in the arch is one possible risk factor, but it's rarely the only one. Training changes are usually the biggest factor.

Can shin splints turn into a stress fracture?
Yes, if training continues without changes. That's why pinpoint bone pain or pain at rest should be checked by a physician.

Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.

About Nova Physical Therapy

Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from sports injuries, back and neck pain, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.

Schedule an evaluation

If shin pain is cutting your runs short, an evaluation can help you find out why and build a plan to get back to running safely.

Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online

Disclaimer

This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Shin pain has several causes, including stress fractures, and only an in-person evaluation, sometimes with imaging, can determine what is right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.

References

1. Medial Tibial Stress Syndrome. StatPearls. NCBI Bookshelf. Link