Good shin splints treatment has two jobs. The first is calming the shin down, which rest, ice and cross-training do well. The second is making your leg able to handle the running that caused the problem, and that is the part most plans skip. Skip it and the pain usually comes back the first week you return to your old mileage. This guide covers both halves, plus how to tell shin splints from something that needs a closer look.
What is the best treatment for shin splints?
The best treatment for shin splints is a short period of relative rest and cross-training, followed by a gradual return to running supported by strength work. The American Academy of Orthopaedic Surgeons (AAOS) recommends resting from the aggravating activity for several weeks, icing for 20 minutes at a time, and waiting until you have been pain-free for at least 2 weeks before running again (AAOS OrthoInfo, Shin Splints). Swimming, stationary cycling and the elliptical keep your fitness up in the meantime.
Limitless Physical Therapy Specialists treats runners and other endurance athletes with shin splints at five clinics across the Rochester area and Cortland, NY, combining a movement assessment with progressive strength work and a planned return to running.
- Settle it: rest from running, ice, and low-impact cross-training for several weeks
- Strengthen it: calf, foot and hip strength so the shin takes less of the load
- Fix the cause: look at training jumps, running mechanics and shoes
- Return gradually: start after 2 pain-free weeks, then build slowly
Shin splints treatment: why rest alone rarely works
Shin splints, which doctors call medial tibial stress syndrome, cause pain along the inner edge of the shinbone. AAOS lists runners as the group at highest risk, followed by dancers and military recruits. A 2020 systematic review of novice and recreational runners called it one of the most common running injuries, with studies reporting it in about 15 to 16% of injured runners (Menéndez et al., 2020).
The same review points to imaging findings that support a newer view of the problem: shin splints look more like a bone stress reaction, where the tibia is being loaded faster than it can adapt, than simple inflammation. The authors are careful to call that hypothesis tentative. Still, it changes how treatment makes sense.
If shin splints are a load problem, rest removes the load and the pain eases. It does nothing to raise how much load your leg can handle. The leg returns to running exactly as able to cope as it was the day the shins started hurting, often a little less, because a few weeks off has cost some fitness. That is the most common reason shin splints come back.
Our position: rest is the first step, not the treatment. The review’s own recommendations line up with this. Its authors suggest a running analysis, technique retraining combined with strength and neuromuscular control exercises, and a gradual running program with planned recovery. Rest gets you to the starting line. Strength and a sensible build-up get you through the season, and if you want help planning both, you can book a shin splints evaluation with our team.
One honest caveat: the research on shin splints treatment is thin. The same review rated the evidence as limited because of poor study quality, and no single treatment has been proven better than the others. That uncertainty is a good reason to treat the causes you can actually see in your own training and mechanics, rather than chasing one fix.
Shin splint stretches and strength work
AAOS includes stretching the lower leg muscles in its advice, and strength matters just as much. Start once walking is comfortable, and keep every exercise pain-free.
Calf stretch against a wall
Facing a wall, step one foot back with the heel down and knee straight, and lean in until the calf stretches. Repeat with the back knee slightly bent to reach the deeper soleus.
Calf raises
Rise onto the balls of both feet and lower slowly, then progress to single-leg raises. Strong calves absorb force that would otherwise travel into the shin.
Toe raises and foot strengthening
Lift your toes and forefoot with your heels down, then lower. Towel toe curls train the small muscles of the foot.
Single-leg balance and hip work
Stand on one leg for 30 seconds, then add side-lying leg raises or banded side steps. The 2020 review linked greater pelvic drop and hip rotation while running to shin splints, and a stronger, steadier hip helps control both.
What usually causes shin splints in the first place
The cause is usually a change, not a single bad run. AAOS names sudden increases in how often, how long or how hard you train, along with flat feet, rigid arches and worn or improper shoes. The 2020 review found that increasing weekly running distance by more than 30% was a risk factor, citing a study by Nielsen and colleagues in 2014.
That points to the most practical prevention tool you have. Build mileage gradually, cross-train on some days, and replace shoes before they are worn out. Running mechanics matter too, since the review flagged pelvic drop, hip rotation and how the foot rolls in among the factors linked to shin splints. A movement assessment can show which of these applies to you.
When you return after a bout of shin splints, the build-up deserves as much planning as the rest did. Start with shorter, easier runs than you were doing before the pain began, on softer surfaces where you can, with a rest or cross-training day between runs at first. Add time before you add speed or hills. If the shin aches the morning after a run, hold at that level for a few more sessions before increasing again. That approach keeps each week’s jump small, well clear of the large increases the research ties to shin splints.
Is it shin splints or a stress fracture?
Shin splints and a tibial stress fracture can feel similar early on, and AAOS notes that a doctor may order imaging such as a bone scan or MRI if shin pain does not respond to treatment. A few signs make a stress fracture more likely and are worth getting checked:
- pain focused on one small spot rather than along a longer stretch of the bone
- pain that continues at rest or wakes you at night
- pain with hopping on the affected leg
- pain that keeps building despite a few weeks of rest
Shin splints are very treatable, and catching a stress fracture early simply means a different plan for a few weeks.
When to see a physical therapist for shin splints
A physical therapist is worth seeing when shin pain keeps returning, when you have a race or season coming up, or when you are not sure what changed. Your first visit is a one-on-one evaluation that covers your training history, how your legs move when you run, and where strength is missing, so the plan targets your actual cause rather than a generic list. Our endurance athlete physical therapy combines movement assessments with progressive strength and mobility work to treat the cause rather than the symptom.
Limitless works with nearly every major insurance carrier, and our billing team checks your coverage before your first appointment. New York requires a referral within 30 days of your first visit, and our front desk can help you sort that out. You can request your first visit through our new patient form.
SHIN SPLINTS REHAB
Tired of shin pain every time you build mileage?
Our team looks at your training, strength and running mechanics, then plans your return to running. We check your insurance first. Prefer to talk? Call (585) 869-5140.
Book your first visitRelated reading for runners: Achilles tendonitis exercises, plantar fasciitis stretches and sprained ankle rehab.
Frequently asked questions
How long do shin splints take to heal?
Most cases settle with several weeks of rest from running, according to AAOS, which also advises being pain-free for at least 2 weeks before returning. Building back to full mileage takes longer, and a gradual plan is what keeps them from returning.
Can I run with shin splints?
It is better not to while the shin is painful. Cross-train instead, and return once you have had 2 pain-free weeks.
Do compression sleeves or new shoes fix shin splints?
They can help, but neither is a fix on its own. AAOS recommends cushioned, supportive shoes and suggests orthotics for flat feet or recurring problems, and an elastic compression bandage can limit swelling early on. The research is mixed on how much these change pain. In one study in the 2020 review, arch-support orthotics changed foot pressure without reducing pain, while another found benefits when orthotics were combined with calf stretching. The pattern is that equipment works best as part of a plan that also adjusts training load and builds strength. If new shoes alone have not solved it, the cause is probably in how much you are running or how your leg is handling it.
Should I ice or heat shin splints?
Ice. AAOS recommends 20 minutes at a time, several times a day, with a cloth between the ice and your skin. If the pain returns after you restart running, stop, ice and rest for a day or two.
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About the Author
This article was written by Dr. Eric Gibbs, PT, DPT, at Limitless Physical Therapy Specialists. Dr. Gibbs earned a B.A. in Exercise Science from SUNY Cortland in 2019 and his Doctorate of Physical Therapy from SUNY Upstate Medical University in 2023. He combines pain relief with a fitness-forward approach and is a marathon runner himself, often logging long runs around the Rochester area. Learn more about Dr. Gibbs and the Limitless team here.
