Introduction
If you’ve ever trained for a race only to be stopped mid‑season by throbbing pain in your lower legs, you know how quickly shin splints can derail progress. Medial tibial stress syndrome—commonly called shin splints—affects nearly one in three runners each year, and many never learn the true cause.
In a recent Doctors of Running Podcast episode, Doug shares his clinical insights on diagnosing, preventing, and treating shin splints.
What What Are Shin Splints? (Understanding the Pain)
Shin splints describe inflammation and irritation along the tibia (shinbone), where muscles and the periosteum—the bone’s outer layer—connect. Instead of a single injury, it’s a *spectrum* of overload. The pain often develops gradually, worsening during or after runs and easing with rest.
Shin splints occur when repetitive stress exceeds tissue tolerance. Common culprits include overtraining, poor shock absorption, and mechanical inefficiencies such as over‑striding or excessive pronation. Without addressing *why* these tissues are overloaded, pain will inevitably return no matter how many ice packs or stretches you apply.
Can You Run Through Shin Splints?
It depends on the severity and how your symptoms behave. Mild discomfort that eases as you warm up might be tolerable; persistent, stabbing pain that lingers afterward means stop immediately. Continuing to run through increasing pain can lead to more serious bone stress injuries.
Instead of full rest, Dr. Adams recommends “active recovery”: cross‑training through cycling, swimming, or deep‑water running. These maintain your aerobic base while minimizing leg impact.
How to Get Race-Ready Despite Shin Pain
If you’re facing an important race, all isn’t lost. Managing load smartly—reducing intensity while preserving volume—can help you reach the start line healthy. Alternate running days with low‑impact sessions and improve your running form to decrease stress.
Communication between coach and clinician is vital. Adjust your taper period and use gait feedback data to ensure your mechanics stay consistent as training volume dips. This balance of activity and rest often allows runners to maintain fitness without sabotaging recovery.
How to Prevent Shin Splints When Running
Preventing shin splints starts long before pain appears. Here are four proven strategies from current research :
1. Follow gradual load progressions. Use principles like Acute to Chronic Workload ratios to help you appropriately increase training.
2. Strengthen the shin and calf complex. Try heel walking, calf raises, and hip strengthening like step ups three times per week.
3. Mix up surfaces. Alternate between roads, tracks, and trails to vary impact loads and improve tissue resilience.
4. Replace worn‑out shoes. Running shoes lose their cushioning after 300–500 miles; rotating between two pairs extends each pair’s lifespan and helps recovery.
Small, consistent training habits build lower‑leg durability that lasts all season.
Shin Splints vs. Stress Fracture: Knowing the Difference
While both conditions cause shin pain, a stress fracture creates sharp, localized pain pinpointed to one small area of bone. Shin splints, by contrast, produce a dull, spread‑out ache that often improves once you’re warmed up.
If you can’t hop on one foot 10 times without high levels of pain—or pain persists more than two weeks—Dr. Adams urges a medical evaluation and imaging before returning to running. Catching a stress fracture early prevents months of forced downtime.
The Real Causes of Shin Splints
The roots of shin splints lie in the load‑to‑tolerance mismatch. Dr. Adams identifies three broad categories:
1. Biomechanical factors: Over‑pronation, low cadence, or excessive overstriding magnify tibial loading.
2. Training errors: Sudden increases in mileage, hill sprints, or high‑intensity sessions without recovery.
3. Equipment or surface issues: Old shoes, hard pavement, or side‑sloped roads that alter running alignment.
Identifying the most relevant cause lets you target your solution—rather than chasing symptoms.
Gait Retraining: The High-Tech Fix
Our work with the Helix 3D shows that small gait adjustments can drastically lower tibial stress. Increasing cadence by 5–10% naturally shortens stride length, decreasing ground‑reaction forces. Cueing runners to “land softly” or “keep steps quiet” further improves joint loading patterns.
A 3D gait analysis pinpoints mechanical inefficiencies and offers precise feedback—a far better approach than trial‑and‑error. These technical tweaks often lead not only to pain reduction but to measurable performance gains.
Managing Training Load More Wisely
Training load management is the ultimate injury‑prevention lever. Plan your schedule around adaptation, not exhaustion. A helpful rhythm: three progressive weeks followed by one lighter week. Track fatigue through heart rate variability, perceived exertion, or motion analysis data.
As Dr. Adams notes, “Rest isn’t wasted time—it’s part of training.” Adjusting effort based on recovery ensures consistent long‑term progress instead of boom‑and‑bust cycles.
For more insights and practical tips, be sure to check out the full episode of the Doctors of Running Podcast with Dr. Doug Adams below!
Do Running Shoes Cause Shin Splints?
Shoes can influence—but rarely *cause*—shin splints. The real goal is compatibility between footwear and your mechanics.
Rotating shoes and updating them regularly keeps mid‑sole foam responsive. Getting a professional gait analysis before purchasing ensures your shoes complement your technique rather than conflict with it.
Key Takeaways
💠Shin splints reflect overuse and imbalance, not just bad luck.
💠 Prevention blends smart progression, strength, surface variety, and shoe care.
💠 Gait retraining provides measurable relief by addressing movement inefficiencies.
💠 Consistent recovery keeps you progressing instead of sidelined.
Closing Thoughts
Every runner experiences minor aches—but persistent shin pain is your body’s feedback, not its failure. By embracing gait analysis, strength training, and smart recovery, you can transform shin splints from a recurring frustration into a learning milestone.
Watch the full episode from Doug’s latest appearance on The Doctors of Running Podcast below.
Dr. Doug Adams and the RunDNA system redefine how athletes approach running health—by tailoring movement strategies to the runner, not forcing the runner to fit the plan.
Follow Dr. Adams on Instagram at @RunDNASystem and @DougAdamsPT, and explore gait analysis solutions here at RunDNA.com to learn how science‑backed motion insight can keep you logging miles pain‑free.