Private shin splints clinic in London, same-day physiotherapy.

Telling them apart

• Shin splints — diffuse ache along the inner shin over several centimetres, worst at the start of a run, often easing as you warm up, sore afterwards.
• Stress fracture — sharp, pinpoint pain over a small area, worsening through activity rather than easing, often painful at night and on hopping.
• Compartment syndrome — tightness, aching and numbness building predictably at a certain distance, resolving within minutes of stopping.
• Imaging is not usually needed for straightforward shin splints, but MRI is the test of choice where a stress fracture is suspected.

What causes it

• A sudden increase in training — distance, frequency, intensity or hills. The single commonest factor.
• Running on hard or cambered surfaces, and worn-out shoes.
• Weak calf and hip muscles, and poor single-leg control.
• Excessive pronation or a very high arch.
• Low vitamin D, low iron, and inadequate energy intake for training load.
• Returning to running after a break at the level you left off.

Getting better

1. Reduce impact load, do not stop entirely. Cut running volume substantially and replace with cycling, swimming, aqua-jogging or cross-trainer to maintain fitness.
2. Build calf strength. Heel raises, straight-knee and bent-knee, progressing to single-leg and then added weight. This is the intervention that most changes recurrence.
3. Add hip and glute work — single-leg control determines how much load reaches the shin.
4. Increase cadence by around 5–10% — shorter, quicker steps reduce impact per stride and are one of the simplest effective changes.
5. Return gradually. Walk-run intervals, on soft flat ground, increasing weekly volume by no more than about 10%.