Let’s start with a quick kinesiology lesson: As you run, every foot strike triggers ground reaction forces that surge back up through your body. These forces can equal nearly three times your bodyweight, research suggests, with most of that stress going into your lower leg. “It makes sense, because the foot hits the ground, and then the shin is right there,” physical therapist Ryan Chow,  founder of Reload Physical Therapy and Fitness tells Runner’s World.

So yeah, shin pain can be one of those frustratingly familiar parts of the sport. But it doesn’t have to be your destiny.

Overuse
Many times, shin pain with running is due to medial tibial stress syndrome, a.k.a. shin splints, which is basically a catch-all term for lower leg pain.

“You’re getting bone pain and overuse to the inside, or medial, part of the tibia,” Dr Samantha Stuek, a sports medicine physician, tells Runner’s World. This pain is typically caused by running too much without giving yourself enough downtime for recovery.

As Stuek explains it: “Whenever we run, there’s always going to be a little bit of load to the bone, and then there’s going to be a little bit of microdamage to the bone, and then recovery.”

But if you load too quickly without enough rest? That’s where inflammation and irritation to the bone can creep in.

Muscle Weakness or Biomechanical Errors
Runners with weak hips or those who pronate (inward movement of the foot), can overly stress their calf muscles and tibialis anterior (a shin muscle that helps with dorsiflexion — the motion of bringing the toes closer to the shin). This can lead to the lower leg muscles getting overworked and not being able to handle the impact of running, and ultimately transferring some of that stress to the tibia, Stuek says.

“When the stress doesn’t go into what’s supposed to absorb the force — which is the muscles and the tendons — then the bones will have to take up the rest of the impact,” Chow explains. And when this impact inflames and irritates the bone, that’s when you have shin splints.

Over time, shin splints can progress to stress reactions (where the bone weakens and swells) or stress fractures (where the bone actually cracks).

As a precursor to shin splints, it’s possible to have more mild shin pain with running that’s simply due to the shin muscles getting overworked without the bones themselves being affected yet. (Also a good sign to slow down on mileage or intensity increases!)

Compartment Syndrome
In rare cases, another cause of shin pain that can mimic shin splints is chronic exertional compartment syndrome. It’s a condition where the increased blood flow that happens during exercise causes the muscles to swell, increasing pressure on the fascia surrounding the muscles, Stuek explains.

Symptoms can include shin pain, muscle spasms, numbness, and sometimes weakness. The condition, which again is rare, often occurs with exercise and resolves shortly with rest.

Cut Back
Good news: If you catch shin splints early, it can typically be resolved within a few weeks by cutting down your running programme and then slowly ramping back into things, Chow says. But if shin pain has been nagging you for months, it might take a lot longer to resolve, he warns.

Now, dialing back your running doesn’t mean you need to quit cold turkey. “If it is true shin splints, you can still keep training,” Stuek says. It’s just a matter of retooling the details to reduce the impact on your bones.

For example, you can incorporate run/walk intervals, swap road workouts for those on softer surfaces like grass or astroturf, and lean on gentler forms of cross-training like cycling, aqua jogging, and the elliptical.

Once your pain improves, you can gradually ramp up your running again, Stuek says. Just be sure to pencil in enough recovery so you don’t backslide. Chow emphasises a holistic definition of recovery — one that includes getting enough sleep, good nutrition, and spacing your workouts correctly — to account for all the stressors in your life, from tough workouts to job stress to family obligations and more.

“There’s one stress cup, and all the stress goes into it, and if you’re overflowing, then you gotta back up,” he says.

Swap Shoes
Updating your shoes can help too if your current kicks are worn out and thus not providing good support, Stuek says. Generally speaking, a more moderately (versus maximally) cushioned shoe could help, though this isn’t a one-size-fits-all prescription, as Runner’s World previously reported.

Build Strength
To double down on eradicating shin splints, incorporate strength training, especially of the calves and quads, Chow says. Bolstering these muscle groups can reduce stress placed on your shins. Chow recommends moves like a bent-knee calf raise and split squat hold.

To reduce shin splints caused by weak hips and pronation, Stuek suggests exercises that target the hip abductors, like lateral steps with a resistance band, as well as moves that strengthen the ankles for improved stability.

Practice Intentional Recovery
She also recommends icing to help reduce inflammation. A simple way to do so: Fill a paper cup with water, pop it in the freezer, and then rub it up and down the area that hurts.

Stretching and massage can provide relief too, focusing on the calves, quads, inner thighs and outer hips, says Chow. So can foam rolling the calves and front of your shins to loosen up areas of tightness, adds Stuek.

Just consider these as ancillary tools and know they won’t overpower the impact of poor programming, Chow says.

For shin pain that’s concentrated in the muscles and not yet the bones, follow the same advice as with shin splints: Scale back your running until the pain improves and incorporate targeted strength work, advises Chow. For temporary pain relief, feel free to use ice, massage, and stretching.

Other warning signs include it worsening over the course of several weeks, as well as pain that’s sharp, causes you to limp, is located on the front of your shin (versus the side), and/or is localised to a small spot (versus covering a large area), Stuek says. Some of these symptoms could indicate serious issues, like a stress fracture, which you’d want to get treated for right away.

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