Shin Pain
Understand What May Be Causing Your Symptoms.
Shin pain can have several different causes. Understanding which tissues may be involved, how they are being loaded and why that load may have become difficult to tolerate is an important part of recovery.
60-90 Minute Specialist Assessment | £185
Not All Shin Pain Is the Same
Shin pain can have several different causes. Medial tibial stress syndrome (MTSS) is a common cause of exercise-related pain along the inside of the shin, but it is not the only possible source of symptoms.
Pain can also involve the muscles and tendons around the lower leg, the bone itself or other structures in the area.
The location and behaviour of your symptoms can provide useful clues, but they do not always tell us exactly which tissue is responsible.
Knowing which tissue is injured is the first step. However, understanding why the tissue has become overloaded is just as important.
Why Does Shin Pain Develop?
Shin pain can develop when the demands placed on a tissue exceed its current capacity to tolerate and recover from load.
This can be influenced by factors such as:
• A rapid increase in running or walking
• Increasing training volume or intensity
• Running on hills or other challenging surfaces
• Returning to activity after a period of reduced training
• Reduced strength or tissue capacity
• Changes in footwear or training surfaces
• Insufficient recovery between sessions
These factors can interact, and what is relevant will vary from person to person.
Understanding what has increased the demand on the tissue is an important part of deciding what needs to change to support recovery.
What Can You Do to Help?
Managing the load on your lower leg can help settle symptoms and create the conditions for recovery.
• Temporarily reduce activities that significantly aggravate your pain.
• Keep active at a level your symptoms can tolerate.
• Gradually increase activity as your symptoms improve.
• Address relevant strength or capacity limitations.
• Consider whether your footwear and training surfaces are appropriate.
• Allow enough recovery between higher-load activities.
Our guide to medial tibial stress syndrome (MTSS) provides more detailed advice on understanding and managing shin pain.
The guide is a useful starting point for managing your symptoms. If your symptoms persist, worsen or do not respond as expected, further assessment may be needed to understand what is contributing to your pain.
How Is Shin Pain Assessed?
Understanding the cause of your symptoms requires more than identifying where the pain is felt.
An assessment considers your symptoms alongside the tissues that may be involved and the factors that could be contributing to their overload.
Clinical Assessment
Your history, symptom behaviour, palpation and relevant clinical tests help identify the structures involved and determine whether further investigation may be appropriate.
Movement & Capacity
Strength, mobility and functional testing help assess how your lower limb tolerates load and whether capacity deficits may be contributing to your symptoms.
Gait & Loading Analysis
Where relevant, video gait analysis and pressure mapping provide further information about how load is being applied through the foot and lower limb..
The findings are brought together to understand which tissue is involved, why it may be overloaded and what needs to change.
How Can Shin Pain Be Treated?
Treatment depends on what is contributing to your symptoms. There is no single treatment that is appropriate for every cause of shin pain.
Your Recovery Plan may include:
Load Modification
Adjusting activity to bring the demands on the affected tissue within its current capacity.
Rehabilitation
Building strength, mobility and tissue capacity where these are relevant to the problem.
Footwear
Considering footwear characteristics that may help manage symptoms and loading.
Orthoses
Where appropriate, orthoses can modify how load is distributed through the foot and lower limb to reduce demand on an affected tissue.
When Might an Assessment Help?
An assessment may be useful if:
- Your symptoms have persisted despite self-management.
- Your pain returns when you increase activity.
- You are unsure what is causing your symptoms.
- Previous treatment has not fully resolved the problem.
- You want to understand what is contributing to your symptoms and what needs to change.
The aim is to identify the factors contributing to your symptoms and develop a clear plan for recovery.