Shin Splints:Why Do They Keep Coming Back?

Shin splints are one of the most common causes of lower-leg pain, especially in runners, athletes, and active individuals. You rest, the pain improves, you return to activity… and then it’s back again.

So why do shin splints keep coming back?

The answer usually isn’t inflammation alone. It’s often a combination of training errors, movement patterns, and biomechanics that continue to overload the shin.

Anatomy Breakdown:

Shin splints involve more than just the shin bone. Key structures include:

• Tibia (Shin Bone): The primary weight-bearing bone that becomes overloaded with repetitive impact.

• Tibialis Posterior: Supports the arch and controls foot pronation; dysfunction increases stress along the inner shin.

• Tibialis Anterior: Helps control foot placement during running and absorbs force at heel strike.

• Calf Muscles (Gastrocnemius & Soleus): Act as shock absorbers; weakness or tightness increases load on the tibia.

• Periosteum: The connective tissue surrounding the tibia that becomes irritated with repetitive pulling forces.

  
  

When these structures don’t work efficiently together, stress accumulates in the shin—leading to recurring pain rather than a one-time injury.

What Are Shin Splints?

Shin splints, also known as medial tibial stress syndrome (MTSS), cause pain along the inner edge of the shin bone (tibia). They develop when repetitive impact and stress overwhelm the muscles, tendons, and bone tissue of the lower leg—something that commonly occurs with running and high-impact activity.

Why Shin Splints Are Recurrent (Especially in Runners)

1. Training Errors: Sudden increases in mileage, speed, intensity, or hill work place excessive stress on the shins, particularly when recovery is inadequate.

2. Poor Foot and Ankle Mechanics: Overpronation, limited ankle mobility, or weak foot muscles increase strain on the tibia with every step.

3. Weak or Imbalanced Muscles: Weak calves, hips, or core muscles reduce shock absorption, forcing the shin to take on more impact during running.

4. Inadequate Recovery: Returning to activity too quickly—without addressing the underlying cause—often leads to repeated flare-ups.

5. Improper Footwear or Running Surface: Worn-out shoes or excessive running on hard or uneven surfaces can significantly increase lower-leg stress.

Why Rest Alone Isn’t Enough

Rest may temporarily reduce pain, but it doesn’t fix the problem. When you return to running with the same mechanics, strength deficits, and training load, the symptoms often return. Without correcting these factors, shin splints become a recurring cycle.

How Physical Therapy Helps Shin Splints

At Matter Rehabilitation Physical Therapy, we focus on long-term solutions—not just short-term relief. Physical therapy for shin splints may include:

• Running gait and movement analysis

• Foot and ankle mobility work

• Strengthening of the calves, hips, and core

• Load management and structured return-to-run planning

• Education on footwear and training progression

  
  

This comprehensive approach helps reduce pain, improve performance, and prevent shin splints from coming back.

When Should You Seek Physical Therapy?

You should consider a physical therapy evaluation if your shin splints:

• Keep coming back/recurrent 

• Limit your workouts or daily activities

• Worsen with activity

• Don’t improve with rest

  
  

Early intervention can prevent shin splints from progressing into stress reactions or stress fractures.

Get Back to Pain-Free Running and Movement

Shin splints don’t have to be part of your training routine. With the right guidance and a personalized plan, you can return to running and activity stronger and more resilient.

Schedule an evaluation with Matter Rehabilitation Physical Therapy and take the first step toward lasting relief.