Shin Splints (MTSS): Causes, Exercises and Return to Running
Shin pain while running can be incredibly frustrating. Just as your fitness begins to improve, you start noticing an ache along your shinbone that makes every run uncomfortable.
For some runners, the pain appears in the first few minutes before settling. Others find that symptoms gradually worsen as the run continues, or that their shins remain sore afterwards.
Often, these symptoms are described as shin splints.
But shin splints is a broad term. Not every runner with shin pain has the same injury, and not every painful shin should be managed by simply stretching the calves or continuing to run.
One of the most common causes of exercise-related pain along the inside of the shin is medial tibial stress syndrome (MTSS).
At RHP Physiotherapy in Kelvin Grove, Brisbane, our sports physiotherapists work with recreational and competitive runners experiencing shin pain, bone stress injuries and other running-related problems.
This article explains what medial tibial stress syndrome is, how to distinguish it from other causes of shin pain, which exercises may help and how to progressively return to running.
Shin Splints: The Short Answer
Shin splints, commonly called medial tibial stress syndrome, involve exercise-related pain along the inner border of the shinbone.
Symptoms are often associated with repeated running or jumping loads that exceed the individual’s current capacity to adapt.
Management generally involves assessing the injury, modifying running loads, maintaining appropriate physical activity, addressing relevant physical limitations and gradually rebuilding running tolerance.
Importantly, focal bone pain, pain during walking or increasingly persistent symptoms can suggest a more significant bone stress injury requiring medical assessment.
What Are Shin Splints?
The term shin splints has historically been used to describe several different causes of pain in the lower leg.
In contemporary sports medicine, medial tibial stress syndrome is a more specific diagnosis.
MTSS typically involves exercise-induced pain along the posteromedial border of the tibia, which is the inner edge of the shinbone.
The pain is usually felt through the middle or lower portion of the shin rather than directly over the ankle or knee.
On examination, familiar tenderness may be reproduced along a relatively broad area of the bone, commonly extending over five centimetres or more.
This is different from the more localised tenderness sometimes found with a tibial stress fracture.
However, tenderness location and length should be considered alongside the history and other findings, not used as standalone diagnostic tests.
What Is Medial Tibial Stress Syndrome (MTSS)?
MTSS is generally considered a load-related condition involving the tissues and bone along the posteromedial tibia.
Older explanations suggested it was primarily caused by muscles pulling repeatedly on the periosteum, the outer covering of the bone, producing inflammation.
This mechanism is sometimes called traction periostitis.
Although the interaction between muscles, connective tissue and bone remains relevant, current thinking gives greater consideration to how the tibia responds to repeated mechanical loading and bone remodelling.
In other words, MTSS is not simply an inflamed muscle attachment.
It involves the relationship between the amount of loading the shin experiences and its capacity to tolerate and adapt to that loading.
Exactly how different bone and soft-tissue processes contribute to MTSS is still being investigated.
Why Do Runners Develop Shin Splints?
Bone is living tissue that continually responds to mechanical stress.
Running provides a repeated stimulus that can contribute to stronger, more capable tissues when training is appropriately progressed.
However, the body’s capacity to adapt is not unlimited.
If running demands increase more rapidly than the person can accommodate, symptoms may develop.
That increase does not necessarily need to be dramatic.
It may reflect a combination of changes in training, recovery or the individual’s current health and physical capacity.
1. A Rapid Increase in Running Volume
A common clinical history involves someone who has recently increased the amount of running they complete.
For example:
- Beginning a running program after several months away.
- Increasing weekly running distance.
- Preparing for a half-marathon or marathon.
- Adding extra running sessions.
- Increasing the length of the weekly long run.
- Returning to football or netball pre-season training.
These changes are not automatically problematic.
Progressively increasing training is how runners improve.
But it is worth considering whether the recent training demands were appropriate for the runner’s existing physical capacity.
2. Changes in Running Intensity
Running faster changes the mechanical demands placed on the lower limb.
A runner who adds intervals, hill sprints or repeated high-speed efforts may substantially increase the loading stimulus even without a large increase in total kilometres.
This can be relevant when shin pain begins during a new training block.
Training volume and intensity therefore need to be considered together.
3. Footwear and Running Surfaces
Changes in footwear, running surfaces or terrain are often reported around the onset of shin pain.
Examples include transitioning to different running shoes, increasing track sessions or moving from regular flat running to more demanding terrain.
These changes may influence the loading demands experienced by the athlete.
However, there is no single shoe type or running surface that can be identified as the cause of MTSS for every runner.
A recent footwear change is worth discussing because of the timing and individual response, not because one type of shoe is inherently harmful.
4. Bone Health, Nutrition and Recovery
When shin pain raises concern about bone stress injury, it is important to consider more than biomechanics.
Other relevant factors may include:
- Previous bone stress injuries.
- Insufficient energy intake relative to exercise demands.
- Low energy availability or Relative Energy Deficiency in Sport (RED-S).
- Menstrual or other hormonal health considerations.
- Bone mineral health.
- Sleep and recovery.
- Other relevant medical conditions or medications.
These factors do not necessarily explain every case of MTSS.
But when an injury appears unusually persistent, severe or recurrent, they can become important parts of the assessment.
Medial Shin Pain vs Anterior Shin Pain: Why the Location Matters
One of the most important parts of assessing shin pain is identifying where the symptoms are occurring.
There is a meaningful clinical distinction between diffuse pain along the inner border of the tibia and more localised pain on the front of the shinbone.
However, location alone cannot reliably determine the diagnosis.
| Presentation | Typical Features | Clinical Consideration |
|---|---|---|
| Medial Tibial Stress Syndrome | Exercise-related pain along the inner tibial border, often with tenderness spread over a relatively broad area. | Assess training load, tissue tolerance and other potential contributors. Exclude more significant bone stress injury when indicated. |
| Posteromedial Tibial Bone Stress Injury | Bone pain associated with impact loading, which may become more persistent or localised as severity increases. | Often considered a lower-risk anatomical location, but still requires appropriate diagnosis and load management. |
| Anterior Tibial Cortex Stress Injury | Often more focal pain and tenderness along the front of the tibia, particularly during loading. | A higher-risk bone stress injury location due to potential healing complications. Prompt medical or sports physician assessment is appropriate. |
| Chronic Exertional Compartment Syndrome | Predictable exercise-related tightness or pressure, sometimes with tingling, weakness or numbness, often improving after stopping. | A different diagnosis requiring clinical assessment and potentially specialist investigation. |
These presentations can overlap, and their symptoms do not always fit neatly into one category.
This is why shin pain should not automatically be labelled shin splints without considering the history and examination.
Why Is an Anterior Tibial Stress Fracture More Concerning?
Bone stress injuries are sometimes described according to whether their anatomical location is associated with a higher or lower risk of healing complications.
The anterior cortex of the tibia is generally considered a higher-risk location.
Compared with many posteromedial tibial injuries, anterior cortical stress injuries are more likely to experience delayed healing or other complications.
The 2025 international consensus on bone stress injuries specifically identifies anterior tibial cortex injuries among higher-risk anatomical sites.
Someone with focal anterior tibial pain, particularly where symptoms are increasing or occurring during ordinary walking, should not simply continue a routine shin-splint exercise program.
Appropriate medical assessment and, where indicated, imaging are important.
When Shin Pain Needs Further Investigation
Arrange prompt assessment if you notice:
- Very localised tenderness over a small area of bone.
- Pain on the front of the tibial shaft.
- Pain that is progressively worsening during runs.
- Symptoms during ordinary walking or standing.
- Persistent pain at rest or during the night.
- Difficulty bearing weight.
- Repeated shin pain despite substantial training modification.
- Relevant risk factors for impaired bone health.
These symptoms do not automatically confirm a stress fracture, but they can change the level of concern.
If a significant bone stress injury is suspected, stop painful running and jumping until an appropriate assessment and loading plan have been established.
Sudden severe leg pain with marked tightness, neurological symptoms or circulation changes requires urgent medical assessment.
How Is Medial Tibial Stress Syndrome Diagnosed?
MTSS is generally a clinical diagnosis based on the history and physical examination.
Assessment may include:
- The location and distribution of pain.
- How symptoms change during and after running.
- Recent changes in training volume and intensity.
- The extent and location of tenderness along the tibia.
- Symptoms during walking and daily activities.
- Relevant lower-limb strength and functional capacity.
- Bone health and other potential risk factors.
Research suggests that MTSS can be diagnosed with reasonable reliability using a structured history and examination.
However, the clinician also needs to consider other causes of shin pain.
Do You Need an MRI for Shin Splints?
Not everyone with shin pain requires imaging.
When the history and examination are consistent with uncomplicated MTSS, rehabilitation can often begin without an MRI.
However, imaging may become important when a tibial bone stress injury is suspected, the presentation is atypical or symptoms are not progressing as expected.
Early bone stress injuries are not always visible on standard X-rays.
MRI can provide important information about bone stress changes and injury severity when clinically indicated.
Higher-risk bone stress injuries may require specialist assessment and different return-to-running criteria.
What Should You Do if Your Shins Hurt While Running?
One of the most common pieces of advice given to runners with shin pain is to rest.
There is some logic to this.
If a particular running load is repeatedly provoking symptoms, reducing that load may be necessary.
But rest does not necessarily mean stopping all physical activity.
And it does not automatically resolve the factors that contributed to symptoms in the first place.
Step 1: Adjust Your Running Load
For someone with a confirmed, uncomplicated MTSS presentation, modifying running may involve:
- Reducing total weekly distance.
- Reducing running frequency.
- Temporarily removing speed sessions.
- Reducing demanding hill or repeated-impact sessions.
- Allowing more recovery between running sessions.
- Temporarily stopping running if symptoms cannot be controlled appropriately.
The amount of change needed varies.
Some runners can continue a reduced amount of running with acceptable symptoms, while others require a complete break from impact activity.
Where a tibial bone stress injury has not been excluded, continuing to run through symptoms is not an appropriate default.
Step 2: Maintain Fitness With Suitable Cross-Training
Many runners understandably worry about losing fitness when they cannot run.
Fortunately, cardiovascular training can often continue through lower-impact activities.
Depending on the injury and individual tolerance, options may include:
- Cycling.
- Swimming.
- Deep-water running.
- Other suitable low-impact conditioning.
These activities should not provoke the injured area.
Maintaining general fitness can make the eventual return to running easier, but it does not replace the need to progressively rebuild tolerance to running-specific impact.
Step 3: Address Relevant Strength and Physical-Capacity Deficits
Strength training is commonly included in rehabilitation for MTSS.
It provides an opportunity to improve lower-limb physical capacity while running exposure is being modified.
However, there is currently no single strengthening program that has been demonstrated to resolve every case of MTSS.
A 2026 systematic review of non-invasive treatments for load-induced medial leg pain found limited and heterogeneous evidence, with no clearly superior treatment identified.
This supports selecting exercises according to the person rather than automatically prescribing an identical routine to every runner.
Exercises for Shin Splints and Medial Tibial Stress Syndrome
The exercises below represent common options used in running rehabilitation.
They are not a universal prescription, and the presence of a suspected bone stress fracture changes what loading may be appropriate.
Once the injury has been appropriately assessed, a rehabilitation program may target the calf, lower-limb musculature, trunk and eventually impact tolerance.
Exercise 1: Straight-Knee Calf Raises
Main focus: Plantarflexor strength, particularly the gastrocnemius contribution.
Begin standing with the knees relatively straight.
Raise the heels from the ground in a controlled manner, then lower slowly.
Progressions may include:
- Double-leg calf raises.
- Single-leg calf raises.
- Additional external resistance.
- Increasing total loading as tolerance improves.
Clinical consideration: The appropriate starting load depends on current symptoms, strength and whether bone stress injury has been excluded.
Exercise 2: Bent-Knee Calf Raises
Main focus: Plantarflexor strength with greater emphasis on the soleus.
The soleus is a major contributor to force production during running.
Training with the knee bent provides a useful way of loading the plantarflexors in a different position from a traditional straight-knee calf raise.
Options include:
- Seated calf raises.
- Bent-knee standing calf raises.
- Loaded seated calf raises.
- Progressively heavier single-leg variations where appropriate.
The goal is to develop useful strength and endurance rather than simply complete as many light repetitions as possible.
Exercise 3: Split Squats and Lunges
Main focus: Quadriceps, gluteal and broader lower-limb strength.
Split squats and lunges can help rebuild strength through the hip, knee and ankle.
Depending on the runner’s capacity, these can progress from bodyweight exercises to more demanding loaded variations.
They are useful general strength exercises, although they have not been established as specific cures for MTSS.
Exercise 4: Hip Strengthening
Main focus: Gluteus maximus, gluteus medius and other hip muscles.
Possible exercises include:
- Step-ups.
- Single-leg Romanian deadlifts.
- Loaded split squats.
- Hip abduction exercises where relevant.
Some runners with MTSS demonstrate particular lower-limb movement characteristics or strength differences.
However, these findings are not consistent across every athlete, and hip weakness should not automatically be presented as the cause of shin pain.
Hip strengthening is most valuable when it addresses a relevant physical limitation or broader training goal.
Exercise 5: Trunk Strength and Control
Main focus: General trunk strength and the ability to manage sporting loads.
Exercises may include:
- Side planks.
- Loaded carries.
- Appropriate anti-rotation exercises.
- Other progressive resistance exercises.
Trunk strengthening can form part of general athletic development, but there is no convincing evidence that every runner with MTSS has a core stability problem.
It should be included when useful, not as a mandatory treatment for everyone.
Exercise 6: Progressive Hopping and Impact Loading
Main focus: Restoring tolerance to the repeated impact demands of running.
Once symptoms, diagnosis and physical capacity permit, rehabilitation can progress towards:
- Double-leg hopping.
- Low-level repeated impact.
- Single-leg hopping.
- Repeated single-leg impact.
- Progressive running drills.
These exercises should not be introduced simply because a fixed number of weeks has passed.
Important: Do not use repeated hopping to test a suspected high-risk tibial bone stress injury without appropriate clinical guidance.
How Often Should You Perform Strength Exercises?
For many runners, two or three appropriately programmed strength sessions each week can provide a useful training structure.
But there is no established MTSS-specific rule that every person must complete exactly two sets of every exercise, or that one repetition range is superior for recovery.
The program should consider:
- The person’s previous strength-training experience.
- Current pain and loading tolerance.
- Other training commitments.
- Whether a bone stress injury is present.
- The specific physical qualities being targeted.
As rehabilitation progresses, exercises can become more demanding to match the runner’s goals.
Our Exercise Physiology and Sports Physiotherapy services can support individualised strength and physical preparation.
Are Orthotics Useful for Shin Splints?
Foot orthoses are sometimes recommended for runners experiencing medial shin pain.
The evidence is mixed.
A 2026 review of non-invasive treatments found that arch-support orthoses, when added to multimodal care, reduced pain in the short term compared with sham orthoses in the included research.
However, benefits were not consistently maintained at longer follow-up.
This does not mean that orthotics are ineffective for everyone.
It means we should be cautious about treating them as a universally necessary or permanently corrective intervention.
What About Foot Posture and Overpronation?
Some studies have identified associations between particular foot characteristics and MTSS.
For example, greater navicular drop has been identified as a potential risk factor in some athletic populations.
However, an association does not mean that every runner with a pronated foot will develop shin splints, or that their foot needs to be corrected.
Foot mechanics vary considerably between healthy runners.
We would therefore consider footwear and orthoses as one part of the assessment rather than assuming there is an ideal foot position for everyone.
Can Strapping Help Decide Whether Orthotics Are Worth Trying?
In clinical practice, taping can sometimes be used to explore whether changing foot support or loading influences symptoms.
For example, a runner may notice that shin discomfort changes when the foot is supported with a particular strapping technique.
That information may help guide discussion about footwear or referral to a podiatrist.
However, a positive response to taping is not a validated test that reliably predicts long-term success with custom orthoses.
The decision should consider the person’s symptoms, preferences, functional goals and response to other management strategies.
Can Running Technique Cause Shin Splints?
Running mechanics influence how loads are distributed through the body.
Step length, running speed, cadence, joint motion and muscle force all interact during running.
But there is no single running technique that is correct for everyone or one movement fault that explains every case of MTSS.
This is an important distinction because runners are sometimes told that shin pain is caused by heel striking, overpronation or having weak hips.
These explanations are often too simplistic.
A running assessment can be useful when it identifies a potentially modifiable factor relevant to the person’s symptoms or physical goals.
However, not every runner needs to change their gait.
Should You Increase Your Running Cadence?
Increasing cadence, or reducing step length, can influence lower-limb loading during running.
This makes gait retraining a plausible option for some runners.
But changes in cadence also redistribute demands across different tissues.
The most appropriate modification depends on the individual.
It is not established that every runner with shin splints should increase their cadence by a fixed percentage.
Running technique should be assessed and modified where there is a clear rationale rather than changed simply because pain is present.
Our Running Physiotherapy service considers running history, physical capacity and movement characteristics as part of a broader assessment.
How Do You Return to Running After Shin Splints?
One of the most important parts of MTSS rehabilitation is restoring the ability to tolerate running.
Improving symptoms during a period of reduced training is useful, but it is not the same as being ready to return to the previous running volume.
The progression should consider the underlying diagnosis, severity, symptoms and broader training goals.
Step 1: Establish That Running Is Appropriate
Before increasing running, consider:
- Whether MTSS or a more significant bone stress injury is present.
- Whether normal walking is comfortable.
- The current level of tenderness and symptom irritability.
- Strength and lower-limb loading capacity.
- Relevant health and training factors.
For confirmed tibial bone stress injuries, published return-to-running guidance emphasises comfortable walking, clinical assessment of local bone tenderness and appropriate functional readiness.
Higher-risk bone stress injuries may also require evidence of healing and medical clearance before running resumes.
Step 2: Begin With a Manageable Running Dose
For a runner who is clinically ready, a return-to-running program may begin with short intervals of easy jogging separated by walking.
The initial dose should be based on what the runner can tolerate rather than using one fixed program for everyone.
For example, someone with mild MTSS may be able to begin with relatively short, comfortable runs.
Someone recovering from a confirmed tibial bone stress injury may require a more cautious, closely monitored walk-run progression.
Step 3: Progress Running Volume Before Speed
When symptoms and physical capacity allow, running duration or total distance can gradually increase.
Faster running, repeated hills and high-intensity intervals can then be reintroduced as appropriate.
A 2024 scoping review of return-to-running criteria following tibial bone stress injury supports an individualised progression, commonly starting with walk-run intervals and developing running distance before speed and intensity.
There is no universal rule that increasing weekly running distance by exactly ten per cent will be safe for every runner.
The progression should reflect the athlete’s current capacity, previous history and response to the training.
Step 4: Monitor Symptoms During and After Running
Useful questions include:
- When does the pain begin during the run?
- Does it remain stable, improve or progressively worsen?
- Is walking uncomfortable afterwards?
- Are symptoms worse later that day or the following morning?
- Is tenderness becoming more localised?
- Is the overall running capacity improving?
Some symptom-guided activity may be appropriate for selected runners with confirmed MTSS.
However, a generic pain-monitoring threshold should not be applied to all tibial bone stress injuries.
Progressively worsening pain, focal tenderness, pain while walking or persistent resting pain should prompt reassessment rather than simply pushing through the next session.
The Return-to-Running Pathway
Establish the diagnosis → modify aggravating running loads → maintain suitable fitness → rebuild relevant strength and capacity → confirm readiness for impact → introduce manageable running → increase volume → progressively restore speed and normal training.
The stages overlap and should be adapted to the individual.
A runner returning from confirmed high-risk bone stress injury may require considerably more protection and medical oversight.
How Long Do Shin Splints Take to Recover?
There is no single recovery time for MTSS.
The course of recovery varies depending on the severity and duration of symptoms, the underlying diagnosis, the amount of loading required for sport and individual health factors.
Some runners improve relatively quickly after modifying training.
Others experience persistent symptoms requiring a longer period of rehabilitation.
More significant tibial bone stress injuries can take considerably longer and may require a separate medical management pathway.
Recovery should therefore be measured through meaningful milestones, including:
- Improved daily function.
- Reduced symptom irritability.
- Improved tolerance to strengthening.
- Readiness for impact activity.
- Gradually increasing running tolerance.
- Return to the person’s desired training and sport.
A useful rehabilitation plan should explain what needs to improve before running demands increase.
Can You Prevent Shin Splints From Returning?
There is no guaranteed way to prevent MTSS.
However, several factors are worth considering when trying to reduce the likelihood of recurrence.
These include:
- Progressively increasing running demands.
- Maintaining strength and physical capacity.
- Considering the total amount of running, jumping and sport being completed.
- Allowing appropriate adaptation to changes in footwear or training conditions.
- Identifying relevant bone health or nutritional concerns.
- Responding to early symptoms before they significantly affect daily activity.
A recent systematic review of preventive strategies reported promising evidence for some neuromuscular training programs and selected foot-orthosis interventions.
However, prevention research should not be confused with evidence that the same intervention will necessarily treat an established episode of MTSS.
And no single approach replaces the need to consider the individual runner’s training and health.
Frequently Asked Questions About Shin Splints
Can You Keep Running With Shin Splints?
Sometimes, but it depends on the diagnosis and severity of symptoms.
Some runners with uncomplicated MTSS may be able to continue a modified amount of running while recovering.
However, running through progressively worsening pain or continuing with a suspected tibial bone stress injury can be inappropriate.
Focal bone tenderness, pain during walking or symptoms at rest warrant assessment before continuing impact training.
Are Shin Splints the Same as a Stress Fracture?
No.
Medial tibial stress syndrome describes a clinical presentation involving exercise-related pain along the posteromedial tibial border.
Tibial bone stress injuries include a spectrum of stress reactions and stress fractures that require assessment according to anatomical location and severity.
Symptoms may overlap, but the diagnoses and appropriate management can differ considerably.
What Exercises Are Best for Shin Splints?
Common rehabilitation exercises include straight-knee and bent-knee calf raises, lower-limb strengthening, selected hip exercises and progressively introduced impact loading.
However, research has not identified one exercise program that is consistently superior for all runners with MTSS.
The best program depends on the diagnosis, current loading tolerance and relevant physical limitations.
Should You Stretch Your Calves for Shin Splints?
Calf stretching may be useful for someone with a relevant mobility limitation, but it is not a proven standalone treatment for medial tibial stress syndrome.
There is no need to repeatedly stretch every painful shin.
Exercise selection should consider the individual’s movement, strength and symptoms.
Do Orthotics Help Shin Splints?
Foot orthoses may improve symptoms in selected runners, particularly in the short term.
However, the research remains limited and does not establish that every runner with MTSS needs orthotics.
Footwear and orthoses are best considered within an individual assessment rather than as automatic corrections for foot posture.
Should I Get an MRI for Shin Pain?
Not every person with shin pain needs imaging.
However, MRI may be important when a tibial bone stress injury is suspected, particularly with focal tenderness, anterior tibial pain, walking pain or progressively persistent symptoms.
The decision should be guided by an appropriate clinical assessment.
Why Do My Shins Hurt When I Start Running Again?
Returning to running after a period away can introduce a loading demand that exceeds your current tolerance.
Changes in distance, frequency, speed, terrain or broader physical capacity may be relevant.
However, not every episode of shin discomfort after restarting running is MTSS, and recurrent symptoms deserve assessment when the diagnosis is unclear.
Can Shin Splints Happen in Football and Netball?
Yes.
Repeated running, jumping and changes in training volume can contribute to exercise-related shin pain in field and court sports.
These athletes may have substantial impact demands from team training and competition in addition to their separate running or gym sessions.
Rehabilitation needs to consider the total physical workload and the eventual demands of the sport.
Shin Splints and Running Injury Physiotherapy in Brisbane
At RHP Physiotherapy in Kelvin Grove, Brisbane, our sports physiotherapists assess running-related shin pain and help distinguish common overuse presentations from injuries requiring further medical investigation.
Our approach considers the runner’s symptoms, training history, physical capacity and the activities they want to return to.
Depending on the presentation, assessment and rehabilitation may include:
- Clinical assessment of tibial pain and tenderness.
- Screening for more significant bone stress injuries.
- Reviewing running volume and intensity.
- Lower-limb strength assessment.
- Calf and soleus strength testing.
- Running movement assessment where relevant.
- Individualised strength rehabilitation.
- Progressive return-to-running planning.
- Medical or sports physician referral when appropriate.
Our Running Physiotherapy service supports recreational and competitive runners managing injuries or working towards their running goals.
For runners needing broader performance preparation, our Sports Physiotherapy and Return to Sport services can also be relevant.
Our clinic is located at AMA Place, 88 L’Estrange Terrace, Kelvin Grove, supporting runners from Brisbane and surrounding suburbs.
The important message is that shin pain should not be reduced to one weak muscle, one running technique or one training error.
Understanding the diagnosis, the runner and the demands being placed on their body is the foundation of a useful rehabilitation plan.
Research Informing This Article
- Fallon K. (2023). Shin Pain in Athletes. Australian Journal of General Practice.
- Hoenig T, et al. (2025). International Delphi Consensus on Bone Stress Injuries in Athletes. British Journal of Sports Medicine.
- George ERM, Sheerin KR, Reid D. (2024). Criteria and Guidelines for Returning to Running Following a Tibial Bone Stress Injury: A Scoping Review. Sports Medicine.
- Load-Induced Medial Leg Pain in Runners: A Systematic Review of Non-Invasive Treatment Approaches. 2026.
- Marques TBT, et al. Preventive Interventions for Medial Tibial Stress Syndrome: Systematic Review and Meta-analysis. Gait & Posture.
- Anderson LM, Bonanno DR, Calnin BJ, et al. (2024). Is the Addition of Running Retraining to Best Standard Care Beneficial in Runners With Medial Tibial Stress Syndrome? Protocol for a Randomised Controlled Trial. Journal of Foot and Ankle Research.
This article provides general health information and does not replace individual assessment or medical advice. Suspected bone stress injuries, particularly at higher-risk anatomical sites, require appropriate clinical assessment before progressing impact exercise.
