Published May 9, 2026 03:31AM
Many runners are all too familiar with the dreaded shin splints. This lower leg pain affects up to one in five runners and contributes to more than half of all lower leg injuries.
The physical pain is bad enough. But shin splints are an emotional drag, too, as they often mean it’s time for a break from running—derailing training blocks, fitness routines, and messing with sleep and mental wellbeing.
The good news is you don’t have to stay off your feet entirely, and there are straightforward ways to manage (and prevent) the pain. Here’s what you need to know about avoiding shin pain when you run.
Common Causes of Shin Pain in Runners
Despite the ubiquity of shin splints, they aren’t the only thing that can cause pain in your lower legs when you run. Here’s what might be behind your discomfort.
1. Shin Splints
A common overuse injury, shin splints feel like pain up and down the shin brought on by activity, explains physical therapist Tara Phaff, DPT, of Re-Form Wellness in Long Island, New York.
Also called medial tibial stress syndrome (MTSS), shin splints are essentially due to a mismatch between how much load you’re placing on your tibia (one of the bones in your lower leg) and that bone’s ability to adapt and recover, explains Hunter Carter, ACSM-EP, CPT, an exercise physiologist at Hospital for Special Surgery in New York City.
This pain is more common in runners with weak glutes and tight IT bands. Combined, this can contribute to “increased inward collapse of the leg and foot during running, which increases repetitive stress on the shin over time,” Phaff says.
That inward collapse can also happen simply due to your unique running mechanics or anatomy, Carter adds.
But shin splints are also common after bumping up your running too quickly, such as “sudden increases in weekly mileage, intensity, hills, or frequency; returning after time off; or stacking hard runs without recovery,” he says.
2. Stress Fracture
The repeated pounding on your legs from running can eventually fracture your tibia. A tibial stress fracture can happen as a result of shin splints if you don’t make adjustments to address that load-recovery mismatch. “MTSS is considered an early marker on the tibial bone-stress continuum, so ‘pushing through’ worsening pain increases the likelihood of progression toward a tibial stress fracture,” Carter says.
Shin pain due to a tibial stress fracture will usually feel sharper, and like it’s in one specific point, compared to pain that’s more spread out, Phaff says.
Running on hard surfaces and/or in sneakers without enough support can increase your risk of a stress fracture in your shins. So can having flat feet or high arches or underlying health conditions that affect your bones, such as osteoporosis.
3. Compartment Syndrome
Technically called “chronic exertional compartment syndrome,” this type of shin pain involves pressure increases in fascial compartments in your legs. These compartments are sections of tough connective tissue that hold muscles, nerves, and blood vessels.
When the pressure there increases, “it can feel like tightness and cramping that occurs with activity and stops with rest,” Phaff says.
Like other types of shin pain in runners, it’s caused by repetitive stress on the lower leg. It can come with other symptoms, such as difficulty moving your feet, numbness in your legs, and visible bulging of your calf muscle.
How to Treat Shin Pain
If you’re in the middle of a run and you notice shin pain, don’t ignore it. “In the moment, shift to a pain-guided approach,” Carter says. “Slow down, shorten the run, switch to walk-run intervals, or stop altogether.”
If you notice higher speed or incline worsens the pain, try to avoid those until you can finish your run (if you’re far from home or your car), he says.
Ice, compression socks, and nonsteroidal anti-inflammatory pain medications like ibuprofen can help ease pain in the short-term, according to the American Academy of Orthopaedic Surgeons.
Over the next few days to weeks, try getting some cardio with lower impact on your lower legs. Cycling, using the elliptical, swimming, or running in a pool can all help, Carter says.
At the same time, incorporate strengthening, mechanics, and stretching exercises that can help alleviate (and prevent) shin pain. When Phaff treats people with shin splints, she focuses on building glute strength, improving flexibility and mobility in the IT band, and potentially strengthening the muscles of the feet and calves for better foot and ankle control during running. Calf, hamstring, and shin stretches may also help. A healthcare professional can help determine the best exercises for you.
Custom-made orthotics or store-bought shoe insoles can help give you more support in your running shoes, which can alleviate and prevent shin pain. It also might be time to replace your running shoes, especially if they’re showing any signs of wear and tear.
Once you can walk without pain, you can often slowly start to run again, Carter says. “It can sometimes be OK to keep running with MTSS, but only when symptoms are mild and clearly stable or improving and you can keep runs truly easy without a pain flare during the run or the next day,” he adds.
To stop the pain from coming back, you might want to consider a professional evaluation of your running mechanics, often called a running gait analysis. These sessions help identify potential issues that could contribute to shin pain. Then, the professional doing the evaluation will create a plan to help correct these pain points. “This type of analysis helps connect what you feel to what your body is doing, so your plan can target technique cues, strength or fatigue deficits, and load progression,” Carter says.
When to See a Doctor
It’s never a bad idea to talk to a doctor or a physical therapist about shin pain from running. But you should definitely bring it up if the pain:
- Is focused in one small area
- Continues at rest or at night
- Gets worse despite scaling back your running for two to three weeks
- Comes with swelling or redness
- Comes with numbness, tingling, or weakness in your legs
Talking to a professional sooner rather than later is a good move: It’ll help you identify the best course of treatment so you can get back out there faster. “Early evaluation is important because stress fractures and compartment syndrome require different management than MTSS,” Phaff says.
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